Active NPI
Mandy Noel Trickey, B.S.
- Physical Therapist
- Victor, NY
National Provider Identifier
1275688376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 021976-1
- Practice address
- 590 Fishers Station Dr
Suite 130
Victor, NY 14564-9744 - Phone
- (585) 924-7207
- Fax
- (585) 924-7049
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 021976-1 | NY | Primary |
Addresses
Primary practice location
590 Fishers Station Dr
Suite 130
Victor, NY 14564-9744
Mailing address
590 Fishers Station Dr
Suite 130
Victor, NY 14564-9744
Phone (585) 924-7207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30-0213081 | Other | NY | TAX ID |
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021976-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western New York Speech-Language Pathology, OT, and PT Consultants | Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Victor, NY
- NPI 1386812550
Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1275688376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 FISHERS STATION DR",
"address_2": "SUITE 130",
"city": "VICTOR",
"state": "NY",
"postal_code": "145649744",
"telephone_number": "585-924-7207",
"fax_number": "585-924-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 FISHERS STATION DR",
"address_2": "SUITE 130",
"city": "VICTOR",
"state": "NY",
"postal_code": "145649744",
"telephone_number": "585-924-7207",
"fax_number": "585-924-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRICKEY",
"first_name": "MANDY",
"middle_name": "NOEL",
"credential": "B.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "021976-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "30-0213081",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.