Organization Active NPI

Form to Thrive Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Webster, NY
National Provider Identifier
1356208680
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FORM TO THRIVE PHYSICAL THERAPY PLLC
Practice address
365 Anna Cir
Webster, NY 14580-9685
Phone
(631) 682-6778
NPI assigned
Jan 8, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Sean Davey, DPTNPI 1386269041
Title
Sole Member
Phone
(631) 682-6778

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

365 Anna Cir
Webster, NY 14580-9685

Mailing address

365 Anna Cir
Webster, NY 14580-9685

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260318003360 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3274017157 Receives reassigned benefits from 1 practitioner
Practice locations: Webster, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1356208680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 ANNA CIR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145809685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 ANNA CIR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145809685",
            "telephone_number": "631-682-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM TO THRIVE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "DAVEY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "631-682-6778",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; 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.