Individual provider Active NPI

Melanie Moffat, PT

  • Physical Medicine & Rehabilitation Physician
  • Le Roy, NY
National Provider Identifier
1194219964
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
015530 Issued in NY
Practice address
3 West Ave
Le Roy, NY 14482-1381
Phone
(585) 768-4550
Fax
(585) 768-2335
NPI assigned
Jun 15, 2018
Last updated
Jun 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 015530 NY Primary

Addresses

Primary practice location

3 West Ave
Le Roy, NY 14482-1381

Mailing address

3 West Ave
Le Roy, NY 14482-1381
Phone (585) 768-4550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200612000305 NY Practitioner - Physical Therapist in Private Practice 2062834492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Rehabilitation LLPGroup PAC ID 4789843376, 114 clinicians

Practice addresses (Care Compare)

500 N Columbus Ave
Mount Vernon, NY 10552-1335
Phone (914) 266-3796

6055 Armor Duells Rd
Orchard Park, NY 14127-3150
Phone (716) 508-3026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015530NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Dec 7, 2024 Accepting new patients
Genesee Valley Physical Therapy & Sports Rehab., P.C. CurrentSince Jul 11, 2024 Accepting new patients

Locations

5 Alva Pl
Batavia, NY 14020
Phone (585) 343-9496

3 West Ave
Le Roy, NY 14482
Phone (585) 224-5179

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1194219964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WEST AVE",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821381",
            "telephone_number": "585-768-4550",
            "fax_number": "585-768-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WEST AVE",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821381",
            "telephone_number": "585-768-4550",
            "fax_number": "585-768-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFAT",
        "first_name": "MELANIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "015530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Roy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.