Health Aquatic Wellness of Chautauqua Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

HEALTH AQUATIC WELLNESS OF CHAUTAUQUA PHYSICAL THERAPY PLLC

Practice address

3266 Fluvanna Avenue Ext
Fluvanna, NY 14701-9706

Phone

(716) 708-6179

Fax

(716) 463-2228

NPI assigned

Dec 20, 2021

Organization subpart

No

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

Authorized official

Name

Kimberly RistauNPI 1548400732

Title

Part Owner

Phone

(814) 688-6119

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Nicole Ristau, PT, DPT

  • Physical Therapist
  • Fluvanna, NY
  • NPI 1548400732
  Medicare reassignment Care Compare group NPD Authorized official
• Candace Marie Brown, PT

  • Physical Therapist
  • Fluvanna, NY
  • NPI 1801810122
  Medicare reassignment Care Compare group NPD
• Daile M Jackson, PT, DPT

  • Physical Therapist
  • Jamestown, NY
  • NPI 1306134267
  Medicare reassignment Care Compare group NPD
• Adam Michael Pangborn, DPT

  • Physical Therapist
  • Fluvanna, NY
  • NPI 1760218291
  Medicare reassignment Care Compare group NPD
• Wayne E Quattrone II, PT, DPT

  • Physical Therapist
  • Fluvanna, NY
  • NPI 1659632966
  Medicare reassignment Care Compare group NPD
• Rosemary J C Williamson, PT, DPT, HFS

  • Physical Therapist
  • Erie, PA
  • NPI 1699197814

  NY

  Medicare reassignment NPD
• Megan E McKinley, PT

  • Physical Therapist
  • Jamestown, NY
  • NPI 1023363702
  NPD

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1144980962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3266 FLUVANNA AVENUE EXT",
            "city": "FLUVANNA",
            "state": "NY",
            "postal_code": "147019706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3266 FLUVANNA AVENUE EXT",
            "city": "FLUVANNA",
            "state": "NY",
            "postal_code": "147019706",
            "telephone_number": "716-708-6179",
            "fax_number": "716-463-2228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Falconer St",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "NY",
            "postal_code": "147011935",
            "country_code": "US",
            "telephone_number": "716-708-6179",
            "fax_number": "716-463-2228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTH AQUATIC WELLNESS OF CHAUTAUQUA PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "RISTAU",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "814-688-6119"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Marie Brown, PT
• Fluvanna Fire District
• Adam Michael Pangborn, DPT
• Wayne E Quattrone II, PT, DPT
• Kimberly Nicole Ristau, PT, DPT

• Physical Therapist in Fluvanna, NY
• Providers in Fluvanna, 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 Sep 2, 2026; 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.