Individual provider Active NPI

Brendan Cacciola

  • Specialist
  • Rochester, NY
National Provider Identifier
1326582438
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
040997-1 Issued in NY
Practice address
309 Exchange Blvd Ste a
Rochester, NY 14608-2708
Phone
(585) 454-4190
NPI assigned
Dec 8, 2016
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 040997-1 NY Primary

Addresses

Primary practice location

309 Exchange Blvd Ste a
Rochester, NY 14608-2708

Mailing address

309 Exchange Blvd Ste a
Rochester, NY 14608-2708
Phone (585) 454-4190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170125002587 NY Practitioner - Physical Therapist in Private Practice 2163704263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry John James Ess IV DO PLLCGroup PAC ID 9436489671, 4 clinicians

Practice addresses (Care Compare)

1865 S Clinton Ave
Suite 180
Rochester, NY 14618-5726
Phone (585) 454-4190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040997-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry John James Ess IV DO PLLC CurrentSince Jun 30, 2022 Accepting new patients
Matson Therapy, LLC CurrentSince Apr 5, 2021 Accepting new patients
William J. Schwarz, P.T., P.C. CurrentSince Jan 2, 2017 Accepting new patients

Locations

5700 Merrick Rd
Massapequa, NY 11758
Phone (516) 798-9605

1865 S Clinton Ave
Ste 180
Rochester, NY 14618
Phone (585) 454-4190

309 Exchange Blvd
Ste A
Rochester, NY 14608
Phone (585) 454-4190

520 N Canyon St
Spearfish, SD 57783
Phone (605) 642-7996

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": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1326582438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 EXCHANGE BLVD STE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146082708",
            "telephone_number": "585-454-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 EXCHANGE BLVD STE A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146082708",
            "telephone_number": "585-454-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCIOLA",
        "first_name": "BRENDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-08",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "040997-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.