Individual provider Active NPI

Jason David Bretcko, DPT

  • Physical Therapist
  • Amherst, NY
National Provider Identifier
1104055045
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-26998 Issued in FL
Practice address
3925 Sheridan Dr
Amherst, NY 14226-1738
Phone
(716) 250-6492
Fax
(716) 250-4178
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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 043062 NY
Physical Therapist 225100000X PT-26998 FL Primary

Addresses

Primary practice location

3925 Sheridan Dr
Amherst, NY 14226-1738

Mailing address

6169 Jog Rd
Suite A11
Lake Worth, FL 33467-6579
Phone (561) 432-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181206000684 NY Practitioner - Physical Therapist in Private Practice 7315108107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2009
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

Merit-based Incentive Payment System (MIPS)

Final score
89.79 of 100Reported as group
Quality
89.94
Promoting interoperability
88
Improvement activities
40
Cost
82.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043062NYMDGeneral Practice Dentistry
PT-26998FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Orthopaedics, LLP CurrentSince Nov 26, 2018 Accepting new patients
Excelsior Orthopaedics LLP Physical Therapist CurrentSince Nov 26, 2018 Accepting new patients

Locations

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

8750 Transit Rd
Ste 105
East Amherst, NY 14051
Phone (716) 636-1470

260 Red Tail Rd
Orchard Park, NY 14127
Phone (716) 675-5711

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jbretcko@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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1104055045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6169 JOG RD",
            "address_2": "SUITE A11",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676579",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        },
        {
            "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": "716-250-6492",
            "fax_number": "716-250-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETCKO",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043062",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT-26998",
            "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 Nov 16, 2018; 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.