Individual provider Active NPI

Michael Dix, D.P.T.

  • Physical Therapist
  • Penfield, NY
National Provider Identifier
1386197143
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
401 Penbrooke Dr
Penfield, NY 14526-2041
Phone
(585) 377-9626
Fax
(585) 377-7513
NPI assigned
Jul 28, 2016
Last updated
Aug 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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 NY Primary

Addresses

Primary practice location

401 Penbrooke Dr
Penfield, NY 14526-2041

Mailing address

2300 Buffalo Rd
BLDG 300a
Rochester, NY 14624-1369
Phone (845) 264-4957

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003000135 NY Practitioner - Physical Therapist in Private Practice 4880981018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesee Valley Physical Therapy and Sports Rehab PCGroup PAC ID 8325029606, 35 clinicians

Practice addresses (Care Compare)

2300 Buffalo Rd
BLDG 300a
Rochester, NY 14624-1369
Phone (716) 247-0080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Valley Physical Therapy & Sports Rehab., P.C. Physical Therapist CurrentSince Aug 24, 2016 Accepting new patients

Locations

2300 Buffalo Rd
Bldg 300A
Rochester, NY 14624
Phone (716) 247-0080

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1386197143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BUFFALO RD",
            "address_2": "BLDG 300A",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241369",
            "telephone_number": "845-264-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PENBROOKE DR",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262041",
            "telephone_number": "585-377-9626",
            "fax_number": "585-377-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIX",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.