Individual provider Active NPI

Brittany Clancy, DPT

  • Physical Therapist
  • Penn Yan, NY
National Provider Identifier
1215358809
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045955 Issued in NY
Practice address
207 1/2 Lake St
Penn Yan, NY 14527-1802
Phone
(315) 536-4051
NPI assigned
Dec 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 40913 CA
Physical Therapist 225100000X 045955 NY Primary

Addresses

Primary practice location

207 1/2 Lake St
Penn Yan, NY 14527-1802

Mailing address

PO Box 725
Mendon, NY 14506-0725
Phone (585) 582-6273

Other practice location 1

2636 Grand Ave Apt 322
San Diego, CA 92109-4838
Phone (585) 919-9640

Other names 1

  • Brittany Lillie Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200915000359 NY Practitioner - Physical Therapist in Private Practice 8022233154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shuman Physical Therapy Associates PCGroup PAC ID 6709869209, 142 clinicians

Practice addresses (Care Compare)

207 /2 Lake St
Penn Yan, NY 14527-1802
Phone (315) 536-4051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 40913CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shuman Physical Therapy Associates, P.C. Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients
Water and Sports Physical Therapy Past Accepting new patients

Locations

207 Lake St
#1-2
Penn Yan, NY 14527
Phone (315) 536-3362

1655 Elmwood Ave
Ste 130
Rochester, NY 14620
Phone (585) 442-9110

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1215358809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "MENDON",
            "state": "NY",
            "postal_code": "145060725",
            "telephone_number": "585-582-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1/2 LAKE ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271802",
            "telephone_number": "315-536-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2636 Grand Ave Apt 322",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921094838",
            "country_code": "US",
            "telephone_number": "585-919-9640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "BRITTANY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 40913",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "LILLIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Penn Yan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.