Active NPI
Alex Houghtalen
- Physical Therapist
- Macedon, NY
National Provider Identifier
1003285313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 039069
- Practice address
- 1900 Route 31
Suite 12
Macedon, NY 14502-8943 - Phone
- (315) 986-4655
- NPI assigned
- Sep 16, 2015
- Last updated
- Sep 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 039069 | NY | Primary |
Addresses
Primary practice location
1900 Route 31
Suite 12
Macedon, NY 14502-8943
Mailing address
1900 Route 31
Suite 12
Macedon, NY 14502-8943
Phone (315) 986-4655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 039069 | Other | NY | NYS LICENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1003285313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 ROUTE 31",
"address_2": "SUITE 12",
"city": "MACEDON",
"state": "NY",
"postal_code": "145028943",
"telephone_number": "315-986-4655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 ROUTE 31",
"address_2": "SUITE 12",
"city": "MACEDON",
"state": "NY",
"postal_code": "145028943",
"telephone_number": "315-986-4655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUGHTALEN",
"first_name": "ALEX",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-16",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "039069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS LICENCE",
"identifier": "039069",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macedon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.