Agnes Leonia Van De Put, PT - Medicare Physical Therapist in Sebastopol, CA

Agnes Leonia Van De Put, PT is a medicare enrolled "Physical Therapist" provider in Sebastopol, California. Her current practice location is 6914 Sebastopol Ave, Sebastopol, California. You can reach out to her office (for appointments etc.) via phone at (707) 327-0998.

Agnes Leonia Van De Put is licensed to practice in California (license number 25323) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1588812721.

Contact Information

Agnes Leonia Van De Put, PT
6914 Sebastopol Ave,
Sebastopol, CA 95472-3459
(707) 327-0998
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameAgnes Leonia Van De Put
GenderFemale
SpecialityPhysical Therapist
Location6914 Sebastopol Ave, Sebastopol, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1588812721
  • Provider Enumeration Date: 08/29/2008
  • Last Update Date: 09/06/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9234292699
  • Enrollment ID: I20211026001256

Medical Identifiers

Medical identifiers for Agnes Leonia Van De Put such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1588812721NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist 2160 (Hawaii)Secondary
225100000XPhysical Therapist 25323 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Agnes Leonia Van De Put allows following entities to bill medicare on her behalf.
Provider NamePatricia D Martinez
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1326180175
PECOS PAC ID: 2264325927
Enrollment ID: I20040209001298

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Agnes Leonia Van De Put is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Agnes Leonia Van De Put, PT
7809 Stefenoni Ct Unit A,
Sebastopol, CA 95472-3536

Ph: (808) 937-3943
Agnes Leonia Van De Put, PT
6914 Sebastopol Ave,
Sebastopol, CA 95472-3459

Ph: (707) 327-0998

Reviews and Comments


Physical Therapist in Sebastopol, CA

Paula Tanksley, PT
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Phone: 707-888-5093    Fax: 707-222-6572
Teresa L Burk, P.T.
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Phone: 707-829-3282    
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Medicare: Not Enrolled in Medicare
Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472
Phone: 707-829-3282    Fax: 707-829-3287
Mrs. Samantha Marie Jacobs, M.S.P.T.
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Medicare: Accepting Medicare Assignments
Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472
Phone: 707-829-3282    Fax: 707-829-3287
Elyse Detweiler Mccluskey, PT
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Medicare: Medicare Enrolled
Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472
Phone: 707-829-3282    Fax: 707-829-3287
Patricia Donovan Martinez, P.T.
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 100 Pleasant Hill Ave N, Sebastopol, CA 95472
Phone: 707-829-3282    Fax: 707-829-3287
Ms. Julie Clare Smith, P.T.
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 500 Swain Ave, Sebastopol, CA 95472
Phone: 707-829-1250    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.