Individual provider Active NPI

Brian H Wrotniak, P.T.

  • Physical Therapist
  • Buffalo, NY
National Provider Identifier
1194049932
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015022 Issued in NY
Practice address
2128 Elmwood Avenue
Buffalo, NY 14207-1910
Phone
(716) 874-4500
Fax
(716) 874-3195
NPI assigned
Mar 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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 015022 NY Primary

Addresses

Primary practice location

2128 Elmwood Avenue
Buffalo, NY 14207-1910

Mailing address

2128 Elmwood Avenue
Buffalo, NY 14207-1910
Phone (716) 874-4500

Other identifiers 1

IdentifierTypeStateIssuer
01465154MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
015022NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1194049932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 ELMWOOD AVENUE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071910",
            "telephone_number": "716-874-4500",
            "fax_number": "716-874-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 ELMWOOD AVENUE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071910",
            "telephone_number": "716-874-4500",
            "fax_number": "716-874-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WROTNIAK",
        "first_name": "BRIAN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.