Individual provider Active NPI

Jennifer Shields, DPT

  • Physical Therapist
  • Webster, NY
National Provider Identifier
1366927162
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
043389 Issued in NY
Practice address
2000 Empire Blvd BLDG 2
Webster, NY 14580-1957
Phone
(585) 671-1030
Fax
(585) 671-1991
NPI assigned
Sep 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 043389 NY Primary

Addresses

Primary practice location

2000 Empire Blvd BLDG 2
Webster, NY 14580-1957

Mailing address

153 Hutchinson Avenue
Ingersoll, ONTARIO N5C3Y6
CA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210001532 NY Practitioner - Physical Therapist in Private Practice 2062756570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shuman Physical Therapy Associates PCGroup PAC ID 6709869209, 142 clinicians

Practice addresses (Care Compare)

2000 Empire Blvd
BLDG 2
Webster, NY 14580-1957
Phone (585) 671-1030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043389NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shuman Physical Therapy Associates, P.C. Physical Therapist CurrentSince Jan 1, 2020 Accepting new patients
Northern Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

349 W Commercial St
Ste 1275
East Rochester, NY 14445
Phone (585) 264-0370

1655 Elmwood Ave
Ste 130
Rochester, NY 14620
Phone (585) 442-9110

2000 Empire Blvd
Bldg 2
Webster, NY 14580
Phone (585) 671-1030

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1366927162",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "153 HUTCHINSON AVENUE",
            "city": "INGERSOLL",
            "state": "ONTARIO",
            "postal_code": "N5C3Y6"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EMPIRE BLVD BLDG 2",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801957",
            "telephone_number": "585-671-1030",
            "fax_number": "585-671-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043389",
            "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 Apr 27, 2020; 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.