Individual provider Active NPI

Bradley Casper

  • Physical Therapist
  • Brockport, NY
National Provider Identifier
1144775156
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040391 Issued in NY
Practice address
92 West Ave
Brockport, NY 14420-1306
Phone
(585) 637-0790
Fax
(585) 637-3572
NPI assigned
Aug 19, 2016
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040391 NY Primary

Addresses

Primary practice location

92 West Ave
Brockport, NY 14420-1306

Mailing address

875 Pre Emption Rd
Ste 3
Geneva, NY 14456-2042
Phone (585) 637-0790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160916000194 NY Practitioner - Physical Therapist in Private Practice 7416243597 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040391NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Nov 1, 2021 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Apr 5, 2023 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

875 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-5061

875 Pre Emption Rd
Ste 3
Geneva, NY 14456

208 State Route 88 S
Newark, NY 14513

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580
Phone (646) 745-0854

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1144775156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 PRE EMPTION RD",
            "address_2": "STE 3",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562042",
            "telephone_number": "585-637-0790",
            "fax_number": "585-637-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201306",
            "telephone_number": "585-637-0790",
            "fax_number": "585-637-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASPER",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.

Verify at the official NPI Registry.