Individual provider Active NPI

Enas Eraqi

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1225406820
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040917 Issued in NY
Practice address
4107 W Genesee St Ste 300
Syracuse, NY 13219-1952
Phone
(315) 635-5000
Fax
(315) 492-1203
NPI assigned
Sep 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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 040917 NY Primary

Addresses

Primary practice location

4107 W Genesee St Ste 300
Syracuse, NY 13219-1952

Mailing address

4502 Southwood Heights Dr
Jamesville, NY 13078-9348
Phone (586) 707-1989

Other practice location 1

6800 E Genesee St
Fayetteville, NY 13066-1089
Phone (315) 635-5000

Other practice location 2

8390 Oswego Rd
Liverpool, NY 13090-1002
Phone (315) 635-5000

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
040917NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Onondaga Physical Therapy, LLC Physical Therapist CurrentSince May 25, 2017 Accepting new patients
Onondaga Physical Therapy, LLC Physical Therapist Current Accepting new patients
Onondaga Physical Therapy Physical Therapist CurrentSince May 25, 2017 Accepting new patients
Onondaga Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

19 E Genesee St
Ste 103
Baldwinsville, NY 13027

7687 Frontage Rd
Cicero, NY 13039
Phone (315) 218-1451

6800 E Genesee St
Fayetteville, NY 13066
Phone (315) 446-4400

8390 Oswego Rd
Liverpool, NY 13090
Phone (315) 652-4323

7575 Buckley Rd
Syracuse, NY 13212
Phone (315) 635-0000

4107 W Genesee St
Ste 300
Syracuse, NY 13219
Phone (315) 877-9747

Organizations & group practices 4

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": "1442102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1225406820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 SOUTHWOOD HEIGHTS DR",
            "city": "JAMESVILLE",
            "state": "NY",
            "postal_code": "130789348",
            "telephone_number": "586-707-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 W GENESEE ST STE 300",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191952",
            "telephone_number": "315-635-5000",
            "fax_number": "315-492-1203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6800 E Genesee St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NY",
            "postal_code": "130661089",
            "country_code": "US",
            "telephone_number": "315-635-5000",
            "fax_number": "315-446-1816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8390 Oswego Rd",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130901002",
            "country_code": "US",
            "telephone_number": "315-635-5000",
            "fax_number": "315-622-1110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERAQI",
        "first_name": "ENAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-13",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.