Individual provider Active NPI

Benjamin Richard Pero, LMT, PTA

  • Massage Therapist
  • Rochester, NY
National Provider Identifier
1184860751
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27 022432 Issued in NY
Practice address
1687 English Rd
Integrated Wellness Systems
Rochester, NY 14616-1609
Phone
(585) 292-6428
NPI assigned
Jan 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 27 022432 NY Primary
Physical Therapy Assistant 225200000X 006353-1 NY

Addresses

Primary practice location

1687 English Rd
Integrated Wellness Systems
Rochester, NY 14616-1609

Mailing address

26 Harlem St
Rochester, NY 14607-2654
Phone (315) 276-0170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006353-1NYMDPhysical Therapy Assistant
27 022432NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1230768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1184860751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 HARLEM ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072654",
            "telephone_number": "315-276-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 ENGLISH RD",
            "address_2": "INTEGRATED WELLNESS SYSTEMS",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146161609",
            "telephone_number": "585-292-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERO",
        "first_name": "BENJAMIN",
        "middle_name": "RICHARD",
        "credential": "LMT, PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-01",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "27 022432",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "006353-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.