Individual provider Active NPI

Kelly Alyse Dreimiller, DPT

  • Physical Therapist
  • Rochester, NY
National Provider Identifier
1023443512
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036549-1 Issued in NY
Practice address
3399 Winton Rd S
Rochester, NY 14623-3057
Phone
(585) 334-6000
Fax
(585) 334-2858
NPI assigned
Sep 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 036549-1 NY Primary

Addresses

Primary practice location

3399 Winton Rd S
Rochester, NY 14623-3057

Mailing address

3399 Winton Rd S
Rochester, NY 14623-3057
Phone (585) 334-6000

Other identifiers 1

IdentifierTypeStateIssuer
00355344MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140414000407 NY Practitioner - Physical Therapist in Private Practice 5890927453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3399 Winton Rd S
Rochester, NY 14623-3057
Phone (585) 334-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036549-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the Rochester Area, Inc. CurrentSince Sep 3, 2013 Accepting new patients
Finger Lakes United Cerebral Palsy, Inc. PastSince Sep 3, 2013 Accepting new patients

Locations

3399 Winton Rd S
Rochester, NY 14623

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1023443512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 WINTON RD S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233057",
            "telephone_number": "585-334-6000",
            "fax_number": "585-334-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 WINTON RD S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233057",
            "telephone_number": "585-334-6000",
            "fax_number": "585-334-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREIMILLER",
        "first_name": "KELLY",
        "middle_name": "ALYSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036549-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355344",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.

Verify at the official NPI Registry.