Individual provider Active NPI

Terrence Michael Rose Jr., DPT

  • Physical Therapist
  • Williamsville, NY
National Provider Identifier
1376856526
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010381-1 Issued in NY
Practice address
180 Park Club LN Ste 225a
Williamsville, NY 14221-5260
Phone
(716) 479-8752
Fax
(716) 674-6070
NPI assigned
Jul 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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 010381-1 NY Primary

Addresses

Primary practice location

180 Park Club LN Ste 225a
Williamsville, NY 14221-5260

Mailing address

180 Park Club LN Ste 225a
Williamsville, NY 14221-5260
Phone (716) 479-8752

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140523000202 NY Practitioner - Physical Therapist in Private Practice 5193909026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susan E Bennett PT PCGroup PAC ID 9133149925, 11 clinicians

Practice addresses (Care Compare)

2075 Sheridan Dr
Suite D
Tonawanda, NY 14223-1425
Phone (716) 803-8220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010381-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Physical Therapy Aquatics and Fitness PC Physical Therapist CurrentSince Apr 27, 2025 Accepting new patients
Susan E Bennett PT PC CurrentSince May 6, 2024 Accepting new patients

Locations

3352 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 662-2922

2075 Sheridan Dr
Ste D
Tonawanda, NY 14223
Phone (716) 803-8220

15 S Forest Rd
Williamsville, NY 14221
Phone (716) 204-8734

180 Park Club Ln
Ste 225A
Williamsville, NY 14221
Phone (716) 276-3567

40 George Karl Blvd
Ste E
Williamsville, NY 14221
Phone (716) 803-8220

Organizations & group practices 3

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1376856526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK CLUB LN STE 225A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215260",
            "telephone_number": "716-479-8752",
            "fax_number": "716-670-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK CLUB LN STE 225A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215260",
            "telephone_number": "716-479-8752",
            "fax_number": "716-674-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TERRENCE",
        "middle_name": "MICHAEL",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010381-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.