Individual provider Active NPI

Theresa Miyashita, PHD, ATC

  • Athletic Trainer
  • Buffalo, NY
National Provider Identifier
1215567342
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
003864 Issued in NY
Practice address
598 Lafayette Ave Unit 207
Buffalo, NY 14222-1481
Phone
(716) 812-8276
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 003864 NY Primary

Addresses

Primary practice location

598 Lafayette Ave Unit 207
Buffalo, NY 14222-1481

Mailing address

598 Lafayette Ave Unit 207
Buffalo, NY 14222-1481
Phone (716) 812-8276

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
003864NYMDSNF/Subacute Care Certified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1215567342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 LAFAYETTE AVE UNIT 207",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221481",
            "telephone_number": "716-812-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 LAFAYETTE AVE UNIT 207",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142221481",
            "telephone_number": "716-812-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASHITA",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "PHD, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003864",
            "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 Jan 16, 2020; 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.