NPIMap

Organization Active NPI

On Track Physical Therapy, LLC

  • Physical Therapist
  • Vestal, NY
National Provider Identifier
1336299700
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008038-1 Issued in NY
Legal business name
ON TRACK PHYSICAL THERAPY, LLC
Practice address
120 Plaza Dr
Suite E
Vestal, NY 13850-3640
Phone
(607) 797-5414
Fax
(607) 797-6537
NPI assigned
Jan 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Louis Boisvert, PTNPI 1780784280
Title
Member
Phone
(607) 797-5414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 008038-1 NY Primary

Addresses

Primary practice location

120 Plaza Dr
Suite E
Vestal, NY 13850-3640

Mailing address

120 Plaza Dr
Suite E
Vestal, NY 13850-3640
Phone (607) 797-5414

Other identifiers 6

IdentifierTypeStateIssuer
S791OtherNYCDPHP
6697064OtherNYGHI PPO
7782695OtherNYAETNA
166468OtherNYEXCELLUS
3949264OtherNYAETNA HMO
02721415MedicaidNY

National Provider Directory

National Provider Directory

Locations

120 Plaza Dr
Ste E
Vestal, NY 13850
Phone (607) 797-5414

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336299700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PLAZA DR",
            "address_2": "SUITE E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503640",
            "telephone_number": "607-797-5414",
            "fax_number": "607-797-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PLAZA DR",
            "address_2": "SUITE E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503640",
            "telephone_number": "607-797-5414",
            "fax_number": "607-797-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON TRACK PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOISVERT",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "607-797-5414",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "008038-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "S791",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "6697064",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7782695",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "166468",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3949264",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02721415",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.