Crystal Anne Duda, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

020377 Issued in NY

Practice address

4205 Long Branch Rd
Liverpool, NY 13090-3213

Phone

(315) 214-3431

Fax

(315) 546-2133

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crystal Waterman Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Bounce Physical Therapy PC

  • Physical Therapist
  • Liverpool, NY
  • NPI 1669529681
  Medicare reassignment NPD Authorized official
• Onondaga Physical Therapy, LLC

  • Physical Therapist
  • Baldwinsville, NY
  • NPI 1548367139
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1144320201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 LONG BRANCH RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903213",
            "telephone_number": "315-214-3431",
            "fax_number": "315-546-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDA",
        "first_name": "CRYSTAL",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02715644",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "WATERMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth M Doyle, LPN
• Robert Albert Dracker, M.D.
• Drakos UC Support Services, LLC
• Erin Driscoll, RD
• Tonjia Droczak
• Erin Marie Duffy, OTR/L
• Robert Ernest Duffy, MS
• Katherine Dunham, MD
• Shaficia Durham
• Keara Margaret Dwyer, PMHNP

• Physical Therapist in Liverpool, NY
• Providers in Liverpool, 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 Nov 24, 2008; 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.