Individual provider Active NPI

Marc Thomas Riley, PT

  • Orthopedic Physical Therapist
  • Horseheads, NY
National Provider Identifier
1114067477
Registry record updated Nov 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
62029776 Issued in NY
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

Updated by the provider on Nov 5, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20111209000503 NY Practitioner - Physical Therapist in Private Practice 9931291630 Reassigns benefits to 1 organization

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
Marc T Riley, PT, PCGroup PAC ID 3577735158, 2 clinicians

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

LicenseStateTypeSpecialty
62029776NYMDOrthopedic Physical Therapist
PT017897PAMDOrthopedic Physical Therapist
RT003170PAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Marc T Riley, PT, PC Orthopedic CurrentSince Nov 1, 2011 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.

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.

Verify at the official NPI Registry.