Individual provider Active NPI

Justin Bader, PT, DPT

  • Physical Therapist
  • Lockport, NY
National Provider Identifier
1245630540
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38586 Issued in FL
Practice address
5848 Snyder Dr
Lockport, NY 14094-9497
Phone
(716) 433-0070
NPI assigned
Aug 25, 2014
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 037446 NY
Physical Therapist 225100000X PT38586 FL Primary

Addresses

Primary practice location

5848 Snyder Dr
Lockport, NY 14094-9497

Mailing address

569 Lenape CT
Suffern, NY 10901-4135
Phone (914) 447-1956

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
037446NYMDGeneral Practice Dentistry
PT38586FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Askenas Chiropractic PC CurrentSince Jan 19, 2015 Accepting new patients
Force Physiotherapy Wynwood LLC Physical Therapist CurrentSince Jan 17, 2024 Accepting new patients
Western New York Physical and Occupational Therapy Group PLLC Physical Therapist Past Accepting new patients

Locations

2250 SW 71st Ter
Davie, FL 33317
Phone (954) 806-5896

2243 N Miami Ave
Ste 110
Miami, FL 33127
Phone (786) 684-8796

67 S Main St
Pearl River, NY 10965
Phone (845) 368-0800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1245630540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 LENAPE CT",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014135",
            "telephone_number": "914-447-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 SNYDER DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949497",
            "telephone_number": "716-433-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "JUSTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037446",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.