Stacy Lynn Wentworth, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0229541 Issued in NY

Practice address

3 West Ave
Leroy, NY 14482

Phone

(585) 768-4550

Fax

(585) 768-2335

NPI assigned

Oct 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Stacy Lynn Defazio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Genesee Valley Physical Therapy & Sports Rehab., P.C.

  • Physical Therapist
  • Rochester, NY
  • NPI 1407910953
  NPD
• Human Performance and Rehabilitation Centers, Inc.

  dba Medical and Health Resources

  • Orthotist
  • Columbus, GA
  • NPI 1437223666
  NPD (past)
• Human Performance and Rehabilitation Centers, Inc.

  dba HPRC, Inc.

  • Physical Therapist
  • Columbus, GA
  • NPI 1609813989
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104908029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 RIDGE MEADOWS DR",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "14559",
            "telephone_number": "585-349-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WEST AVE",
            "city": "LEROY",
            "state": "NY",
            "postal_code": "14482",
            "telephone_number": "585-768-4550",
            "fax_number": "585-768-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0229541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "DEFAZIO",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey C. Waliszewski, NP
• Samantha Walker, LMSW
• Lauren Weber, PT, DPT
• Polly Ann Welch, DPT
• Gail A Welsh, P.T
• Margaret Susan Wetzel, LPN
• Sandra Whiting
• Willcare
• Sharon Ann Woodward
• Kayla Anne Wright

• Physical Therapist in Le Roy, NY
• Providers in Le Roy, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.