Active NPI
Mary Mauro-Bertolo, PT
- Physical Therapist
- Cicero, NY
National Provider Identifier
1366441248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007911-1
- Practice address
- 6221 Rte 31 Ste 103
Cicero, NY 13039 - Phone
- (315) 699-1009
- Fax
- (315) 699-1094
- NPI assigned
- Jul 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007911-1 | NY | Primary |
Addresses
Primary practice location
6221 Rte 31 Ste 103
Cicero, NY 13039
Mailing address
6221 Rte 31 Ste 103
Cicero, NY 13039
Phone (315) 699-1009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007911-1 | NY | MD | Physical Therapist |
| 007911 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1366441248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6221 RTE 31 STE 103",
"city": "CICERO",
"state": "NY",
"postal_code": "13039",
"telephone_number": "315-699-1009",
"fax_number": "315-699-1094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6221 RTE 31 STE 103",
"city": "CICERO",
"state": "NY",
"postal_code": "13039",
"telephone_number": "315-699-1009",
"fax_number": "315-699-1094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAURO-BERTOLO",
"first_name": "MARY",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "007911-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.