Individual provider Active NPI

Jaden Gillette, PT, DPT

  • Orthopedic Physical Therapist
  • Amherst, NY
National Provider Identifier
1023840667
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
052694 Issued in NY
Practice address
3925 Sheridan Dr
Amherst, NY 14226-1738
Phone
(716) 250-9999
NPI assigned
Aug 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 052694 NY Primary

Addresses

Primary practice location

3925 Sheridan Dr
Amherst, NY 14226-1738

Mailing address

21 Coolbrook CT
Apartment D
East Amherst, NY 14051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912003993 NY Practitioner - Physical Therapist in Private Practice 7214477587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelsior Orthopaedics LLPGroup PAC ID 2062491517, 146 clinicians

Practice addresses (Care Compare)

3925 Sheridan Dr
Amherst, NY 14226-1738
Phone (716) 250-9999

6831 Seneca St
Suite a
Elma, NY 14059-9520
Phone (716) 906-5564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052694NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics LLP Orthopedic CurrentSince Aug 19, 2024 Accepting new patients
Excelsior Orthopaedics, LLP CurrentSince Aug 19, 2024 Accepting new patients

Locations

3925 Sheridan Dr
Buffalo, NY 14226
Phone (716) 250-6500

Interoperability endpoints

  • Direct secure messaging: jgillette@excelsiorortho.medentdirect.com

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": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1023840667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COOLBROOK CT",
            "address_2": "APARTMENT D",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "14051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261738",
            "telephone_number": "716-250-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JADEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "052694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.