NPIMap

Organization Active NPI

Perilli Physical Therapy PC

Doing business as Advantage Physical Therapy

  • Physical Therapist
  • Lockport, NY
National Provider Identifier
1043891765
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PERILLI PHYSICAL THERAPY PC
Doing business as
Advantage Physical Therapy
Practice address
5556 Davison Rd
Lockport, NY 14094-9090
Phone
(716) 433-3368
Fax
(716) 433-2086
NPI assigned
Apr 15, 2021
Last updated
Apr 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Authorized official

Name
Karri Essenburg
Title
Office Manager
Phone
(716) 433-3368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

5556 Davison Rd
Lockport, NY 14094-9090

Mailing address

5556 Davison Rd
Lockport, NY 14094-9090
Phone (716) 433-3368

Other names 1

  • Advantage Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210505002166 NY Part B Supplier - Clinic/Group Practice 0941619845 Receives reassigned benefits from 5 practitioners
Practice locations: Lockport, NY

National Provider Directory

National Provider Directory

Locations

5556 Davison Rd
Lockport, NY 14094
Phone (716) 433-3368

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1043891765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5556 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949090",
            "telephone_number": "716-433-3368",
            "fax_number": "716-433-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5556 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949090",
            "telephone_number": "716-433-3368",
            "fax_number": "716-433-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERILLI PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "ESSENBURG",
        "authorized_official_first_name": "KARRI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "716-433-3368"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.