Active NPI
Michael Hlywa, PT
- Specialist
- Baldwinsville, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 13530
- Practice address
- 3070 Belgium Rd
Baldwinsville, NY 13027-9239 - Phone
- (315) 638-0173
- Fax
- (315) 638-0754
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 13530 | NY | Primary |
| Physical Therapist | 225100000X |
Addresses
Primary practice location
3070 Belgium Rd
Baldwinsville, NY 13027-9239
Mailing address
207 Pine St
Syracuse, NY 13210-1137
Phone (315) 476-3175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- State University of New York Downstate Medical Center, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
207 Pine St
Syracuse, NY 13210-1137
Phone (315) 476-3176
3090 Belgium Rd
Baldwinsville, NY 13027-9239
Phone (315) 638-0173
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13530 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson & Nellis Physical Therapy PC | Specialist | Current | Accepting new patients |
Locations
3090 Belgium Rd
#31
Baldwinsville, NY 13027
3070 Belgium Rd
Baldwinsville, NY 13027
Phone (315) 635-5700
3090 Belgium Rd
Baldwinsville, NY 13027
Phone (315) 638-0173
3400 Seneca Tpke
Ste 7
Canastota, NY 13032
Phone (315) 697-8514
207 Pine St
Syracuse, NY 13210
Phone (315) 476-3175
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Syracuse, NY
- NPI 1033291802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297296000000",
"number": "1013099878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 PINE ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101137",
"telephone_number": "315-476-3175",
"fax_number": "315-476-0171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3070 BELGIUM RD",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130279239",
"telephone_number": "315-638-0173",
"fax_number": "315-638-0754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HLYWA",
"first_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2011-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "13530",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baldwinsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.