Individual provider Active NPI

Susan Barjaktarevic, PT

  • Physical Therapist
  • Cazenovia, NY
National Provider Identifier
1255038535
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054461 Issued in NY
Practice address
29 Gillette LN
Cazenovia, NY 13035-1403
Phone
(720) 251-0662
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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 054461 NY Primary
Pediatric Physical Therapist 2251P0200X PTL.0017048 CO

Addresses

Primary practice location

29 Gillette LN
Cazenovia, NY 13035-1403

Mailing address

29 Gillette LN
Cazenovia, NY 13035-1403
Phone (720) 251-0662

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260121003000 NY Practitioner - Physical Therapist in Private Practice 2163909169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

29 Gillette LN
Cazenovia, NY 13035-1403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054461NYMDPharmacist
PTL.0017048COMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Small Steps Physical Therapy PLLC Physical Therapist CurrentSince Dec 12, 2025 Accepting new patients
Small Steps Pediatric Physical Therapy LLC Pediatrics CurrentSince Feb 12, 2023 Accepting new patients

Organizations & group practices 2

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1255038535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 GILLETTE LN",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130351403",
            "telephone_number": "720-251-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 GILLETTE LN",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130351403",
            "telephone_number": "720-251-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARJAKTAREVIC",
        "first_name": "SUSAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054461",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CO",
            "license": "PTL.0017048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cazenovia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.