Active NPI
Marc Thomas Riley, PT
- Orthopedic Physical Therapist
- Horseheads, NY
National Provider Identifier
1114067477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 62029776
- Practice address
- 2667 Corning Rd
Horseheads, NY 14845-4202 - Phone
- (607) 739-1700
- Fax
- (607) 739-1792
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT017897 | PA | |
| Athletic Trainer | 2255A2300X | RT003170 | PA | |
| Orthopedic Physical Therapist | 2251X0800X | 62029776 | NY | Primary |
Addresses
Primary practice location
2667 Corning Rd
Horseheads, NY 14845-4202
Mailing address
808 W Church St
Elmira, NY 14905-2324
Phone (607) 346-7587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
133 N Main St
Horseheads, NY 14845-2175
Phone (607) 739-1700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62029776 | NY | MD | Orthopedic Physical Therapist |
| PT017897 | PA | MD | Orthopedic Physical Therapist |
| RT003170 | PA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc T Riley, PT, PC | Orthopedic | Current | Accepting new patients |
| Elite Therapy PC | Orthopedic | Past | Accepting new patients |
Locations
133 N Main St
Horseheads, NY 14845
Phone (607) 739-0583
2667 Old Corning Rd
Horseheads, NY 14845
Phone (607) 333-4778
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.
-
- Orthopedic Physical Therapist
- Horseheads, NY
- NPI 1538441019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320451200000",
"number": "1114067477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 W CHURCH ST",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149052324",
"telephone_number": "607-346-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2667 CORNING RD",
"city": "HORSEHEADS",
"state": "NY",
"postal_code": "148454202",
"telephone_number": "607-739-1700",
"fax_number": "607-739-1792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "MARC",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2011-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "PA",
"license": "PT017897",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT003170",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NY",
"license": "62029776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Horseheads, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2011; 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.