NPIMap

Organization Active NPI

Home Stretch Physical Therapy , P.C.

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1326483785
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024295 Issued in NY
Legal business name
HOME STRETCH PHYSICAL THERAPY , P.C.
Practice address
4279 Crested Butte Run
Syracuse, NY 13215-1355
Phone
(315) 569-9308
Fax
(315) 295-2579
NPI assigned
Apr 29, 2013
Last updated
Apr 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Mr. Alexander Talev, PTNPI 1114230414
Title
President
Phone
(315) 569-9308

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 Therapist 225100000X 024295 NY Primary

Addresses

Primary practice location

4279 Crested Butte Run
Syracuse, NY 13215-1355

Mailing address

4279 Crested Butte Run
Syracuse, NY 13215-1355
Phone (315) 569-9308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160712000668 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981996923 Receives reassigned benefits from 17 practitioners
Practice locations: Syracuse, NY; Fayetteville, NY; North Syracuse, NY; Manlius, NY; Liverpool, NY; Jamesville, NY

National Provider Directory

National Provider Directory

Locations

5125 Highbridge St
Fayetteville, NY 13066
Phone (315) 637-2000

100 Summerfield Village Ln
Syracuse, NY 13215
Phone (315) 492-4041

1100 James St
Syracuse, NY 13203
Phone (315) 474-1478

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1326483785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4279 CRESTED BUTTE RUN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151355",
            "telephone_number": "315-569-9308",
            "fax_number": "315-295-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 CRESTED BUTTE RUN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151355",
            "telephone_number": "315-569-9308",
            "fax_number": "315-295-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME STRETCH PHYSICAL THERAPY , P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "TALEV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-569-9308",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.