Scott Bronstad, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P03396 Issued in NY

Practice address

2812 State Route 174
Marietta, NY 13110-3202

Phone

(347) 924-2720

NPI assigned

Aug 29, 2016

Last updated

Aug 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1336695451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 STATE ROUTE 174",
            "city": "MARIETTA",
            "state": "NY",
            "postal_code": "131103202",
            "telephone_number": "347-924-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 STATE ROUTE 174",
            "city": "MARIETTA",
            "state": "NY",
            "postal_code": "131103202",
            "telephone_number": "347-924-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSTAD",
        "first_name": "SCOTT",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "P03396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Marietta, NY
• Providers in Marietta, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.