Individual provider Active NPI

Martin Ryan Koslosky, PT

  • Physical Therapist
  • Buffalo, NY
National Provider Identifier
1194978874
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028492-1 Issued in NY
Practice address
2625 Delaware Ave
Buffalo, NY 14216-1705
Phone
(716) 874-2759
Fax
(716) 874-2913
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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 028492-1 NY Primary

Addresses

Primary practice location

2625 Delaware Ave
Buffalo, NY 14216-1705

Mailing address

57C Park Club LN
Williamsville, NY 14221-5201
Phone (716) 308-4875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000476 NY Practitioner - Physical Therapist in Private Practice 7810058377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin R Koslosky PT PCGroup PAC ID 1850670555, 3 clinicians

Practice addresses (Care Compare)

2625 Delaware Ave
Suite 106
Buffalo, NY 14216-1705
Phone (716) 874-2759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028492NYMDPharmacist
028492-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin R Koslosky ,PT ,P.C. Physical Therapist CurrentSince Sep 26, 2016 Accepting new patients

Locations

2625 Delaware Ave
Buffalo, NY 14216
Phone (716) 447-6450

2625 Delaware Ave
Ste 106
Buffalo, NY 14216
Phone (716) 874-2759

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1194978874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57C PARK CLUB LN",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215201",
            "telephone_number": "716-308-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161705",
            "telephone_number": "716-874-2759",
            "fax_number": "716-874-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSLOSKY",
        "first_name": "MARTIN",
        "middle_name": "RYAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028492-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 28, 2008; 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.