Active NPI
Mark Jospeh Siedlecki, PT, DPT
- Physical Therapist
- Williamsville, NY
National Provider Identifier
1124689542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 043405
- Practice address
- 111 N Maplemere Rd Ste 100
Williamsville, NY 14221-3182 - Phone
- (716) 204-3200
- Fax
- (716) 204-4337
- NPI assigned
- Jun 26, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 043405 | NY | Primary |
Addresses
Primary practice location
111 N Maplemere Rd Ste 100
Williamsville, NY 14221-3182
Mailing address
4225 Genesee St Ste 400
Cheektowaga, NY 14225-1994
Phone (716) 204-3200
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, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5848 Snyder Dr
Lockport, NY 14094-9497
Phone (716) 433-0070
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043405 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Mechanix Physical Therapy PLLC | Physical Therapist | Current | Accepting new patients |
| Western New York Physical and Occupational Therapy Group PLLC | Physical Therapist | Past | Accepting new patients |
Locations
5848 Snyder Dr
Lockport, NY 14094
Phone (716) 433-0070
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.
-
- Physical Therapy Clinic/Center
- Lockport, NY
- NPI 1063517662
Physical Therapist
-
- Physical Therapist
- Depew, NY
- NPI 1881647261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1124689542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4225 GENESEE ST STE 400",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251994",
"telephone_number": "716-204-3200",
"fax_number": "716-204-4337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N MAPLEMERE RD STE 100",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142213182",
"telephone_number": "716-204-3200",
"fax_number": "716-204-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEDLECKI",
"first_name": "MARK",
"middle_name": "JOSPEH",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-26",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "043405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.