Organization Active NPI

Sprout Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Rochester, NY
National Provider Identifier
1225825193
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPROUT PHYSICAL THERAPY PLLC
Practice address
2775 Buffalo Rd
Rochester, NY 14624-1372
Phone
(585) 290-1490
NPI assigned
Apr 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Marietta Joanne PhillipsNPI 1104960343
Title
Physical Therapy
Phone
(585) 290-1490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2775 Buffalo Rd
Rochester, NY 14624-1372

Mailing address

45 Tellidora TRL
Spencerport, NY 14559-9404
Phone (585) 489-9775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250609000610 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5698285781 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

2775 Buffalo Rd
Rochester, NY 14624
Phone (585) 290-1490

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1225825193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TELLIDORA TRL",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145599404",
            "telephone_number": "585-489-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 BUFFALO RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241372",
            "telephone_number": "585-290-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MARIETTA",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "PHYSICAL THERAPY",
        "authorized_official_telephone_number": "585-290-1490"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.