NPIMap

Organization Active NPI

Daemen University Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Buffalo, NY
National Provider Identifier
1336584473
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
DAEMEN UNIVERSITY PHYSICAL THERAPY INC
Practice address
21 Persia Street
Buffalo, NY 14211-2131
Phone
(716) 839-8218
NPI assigned
May 2, 2013
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
Dr. Michael S Brogan, DPTNPI 1013112929
Title
President
Phone
(716) 839-8227

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

21 Persia Street
Buffalo, NY 14211-2131

Mailing address

21 Persia Street
Buffalo, NY 14211-2131

Other names 1

  • Daemen College Physical Therapy Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130903000270 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7012150519 Receives reassigned benefits from 2 practitioners
Practice locations: Buffalo, NY

National Provider Directory

National Provider Directory

Locations

4380 Main St
Ste DS106
Amherst, NY 14226

Practitioners & affiliated clinicians

Practitioners 7

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": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1336584473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PERSIA STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142112131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PERSIA STREET",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142112131",
            "telephone_number": "716-839-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAEMEN UNIVERSITY PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "BROGAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-839-8227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daemen College Physical Therapy Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Daemen College Physical Therapy Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.