NPIMap

Organization Active NPI

Warner Physical Therapy PC

  • Physical Therapist
  • Oswego, NY
National Provider Identifier
1235150392
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021649 Issued in NY
Legal business name
WARNER PHYSICAL THERAPY PC
Practice address
364 East Ave
Oswego, NY 13126-6148
Phone
(315) 326-0056
Fax
(315) 326-0102
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Brian C Warner, PTNPI 1689691198
Title
Owner
Phone
(315) 326-0056

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 021649 NY Primary

Addresses

Primary practice location

364 East Ave
Oswego, NY 13126-6148

Mailing address

364 East Ave
Oswego, NY 13126-6148
Phone (315) 326-0056

Other practice location 1

20053 Summit View Blvd
Ste 2
Watertown, NY 13601
Phone (315) 681-4187

Other identifiers 1

IdentifierTypeStateIssuer
02622993MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122000237 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8527023332 Receives reassigned benefits from 10 practitioners
Practice locations: Oswego, NY; Watertown, NY

National Provider Directory

National Provider Directory

Locations

364 East Ave
#1
Oswego, NY 13126

364 East Ave
Oswego, NY 13126
Phone (315) 326-0056

20053 Summit View Blvd
Ste 2
Watertown, NY 13601
Phone (315) 681-4187

20053 Summit View Blvd
Watertown, NY 13601
Phone (315) 681-4187

Practitioners & affiliated clinicians

Practitioners 12

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1235150392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 EAST AVE",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266148",
            "telephone_number": "315-326-0056",
            "fax_number": "315-326-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 EAST AVE",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266148",
            "telephone_number": "315-326-0056",
            "fax_number": "315-326-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20053 Summit View Blvd",
            "address_2": "Ste 2",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "13601",
            "country_code": "US",
            "telephone_number": "315-681-4187",
            "fax_number": "315-661-6068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WARNER PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-326-0056",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02622993",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.