Individual provider Active NPI

Roland Richard Alley, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1336572957
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036432 Issued in NY
Practice address
95 University PL
8TH Floor
New York, NY 10003-4515
Phone
(212) 604-1316
Fax
(646) 291-8025
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 036432 NY Primary

Addresses

Primary practice location

95 University PL
8TH Floor
New York, NY 10003-4515

Mailing address

95 University PL
8TH Floor
New York, NY 10003-4515
Phone (212) 604-1316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131108000964 NY Practitioner - Physical Therapist in Private Practice 2668607193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

652 Route 299
Suite 204
Highland, NY 12528-2933
Phone (845) 579-5007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036432NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gunks Physical Therapy, PLLC Physical Therapist CurrentSince Aug 13, 2022 Accepting new patients
Holt Chiropractic Offices, P.C. Past Accepting new patients

Locations

652 Route 299
#204
Highland, NY 12528
Phone (845) 579-5007

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, 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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1336572957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 UNIVERSITY PL",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034515",
            "telephone_number": "212-604-1316",
            "fax_number": "646-291-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 UNIVERSITY PL",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034515",
            "telephone_number": "212-604-1316",
            "fax_number": "646-291-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEY",
        "first_name": "ROLAND",
        "middle_name": "RICHARD",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.