Individual provider Active NPI

Alec David Lavere, DPT

  • Physical Therapist
  • Orchard Park, NY
National Provider Identifier
1083293724
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41855 Issued in FL
Practice address
6055 Armor Duells Rd
Orchard Park, NY 14127-3150
Phone
(716) 508-3026
NPI assigned
Apr 7, 2021
Last updated
Sep 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 046595 NY
Physical Therapist 225100000X PT41855 FL Primary

Addresses

Primary practice location

6055 Armor Duells Rd
Orchard Park, NY 14127-3150

Mailing address

455 Sarah Nicole Way
New Smyrna Beach, FL 32168-5416
Phone (716) 908-6242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046595NYMDPharmacist
PT41855FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1083293724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SARAH NICOLE WAY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321685416",
            "telephone_number": "716-908-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 ARMOR DUELLS RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273150",
            "telephone_number": "716-508-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERE",
        "first_name": "ALEC",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046595",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.