NPIMap

Organization Active NPI

Peterson & Nellis Physical Therapy PC

Doing business as Physical Therapy Plus

  • Specialist
  • Syracuse, NY
National Provider Identifier
1033291802
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PETERSON & NELLIS PHYSICAL THERAPY PC
Doing business as
Physical Therapy Plus
Practice address
207 Pine St
Syracuse, NY 13210-1137
Phone
(315) 476-3176
Fax
(315) 476-0171
NPI assigned
Oct 20, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. James B Rosier
Title
Executive Director
Phone
(315) 476-3176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

207 Pine St
Syracuse, NY 13210-1137

Mailing address

207 Pine St
Syracuse, NY 13210-1137
Phone (315) 476-3176

Other names 1

  • Physical Therapy Plus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040508000189 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022007756 Receives reassigned benefits from 9 practitioners
Practice locations: Baldwinsville, NY; Canastota, NY; Fulton, NY; Syracuse, NY

National Provider Directory

National Provider Directory

Locations

3070 Belgium Rd
#31
Baldwinsville, NY 13027
Phone (315) 638-0173

3090 Belgium Rd
Baldwinsville, NY 13027
Phone (315) 638-0173

3400 Seneca Tpke
Ste 7
Canastota, NY 13032
Phone (315) 697-8514

113 Schuyler St
Ste 7
Fulton, NY 13069
Phone (315) 593-1740

207 Pine St
Syracuse, NY 13210
Phone (315) 476-3175

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1033291802",
    "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": "315-476-3176",
            "fax_number": "315-476-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 PINE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101137",
            "telephone_number": "315-476-3176",
            "fax_number": "315-476-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON & NELLIS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROSIER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-476-3176",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.