Active NPI
Julie Ann Prattico, DPT
- Physical Therapist
- Rochester, NY
National Provider Identifier
1134415482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 037537-1
- Practice address
- 1100 Long Pond Rd
Suite 222a
Rochester, NY 14626-1177 - Phone
- (585) 697-0207
- Fax
- (585) 697-0209
- NPI assigned
- Jun 24, 2011
- Sex
- Female
- 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 | 037537-1 | NY | Primary |
Addresses
Primary practice location
1100 Long Pond Rd
Suite 222a
Rochester, NY 14626-1177
Mailing address
6319 Fly Rd Ste 4
East Syracuse, NY 13057-4900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196518200 | Medicaid | MD | |
| 6357 | Other | DC | CARE FIRST OF NCA |
| S936SO | Other | MD | CARE FIRST OF MARYLAND |
Other names 1
- Julie Ann Paska
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141029001280 | NY | Practitioner - Physical Therapist in Private Practice | 2769603075 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037537-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports Physical Therapy of New York, PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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 Therapist
- Rochester, NY
- NPI 1922396886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1134415482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6319 FLY RD STE 4",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130574900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 LONG POND RD",
"address_2": "SUITE 222A",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146261177",
"telephone_number": "585-697-0207",
"fax_number": "585-697-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATTICO",
"first_name": "JULIE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-24",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "037537-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196518200",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST OF NCA",
"identifier": "6357",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST OF MARYLAND",
"identifier": "S936SO",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "PASKA",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.