Active NPI
John M Pitarresi, P.T.
- Physical Therapist
- Hamburg, NY
National Provider Identifier
1386748770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007944-1
- Practice address
- 6091 S Park Ave
Hamburg, NY 14075-3734 - Phone
- (716) 649-5789
- Fax
- (716) 646-0853
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- 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 | 007944-1 | NY | Primary |
Addresses
Primary practice location
6091 S Park Ave
Hamburg, NY 14075-3734
Mailing address
4566 Copperfield Dr
Hamburg, NY 14075
Phone (716) 648-1235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01018859 | Medicaid | NY |
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 |
|---|---|---|---|
| 007944-1 | NY | MD | Occupational Therapy Assistant |
| 007944 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascend Physical Therapy Group | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Buffalo, NY
- NPI 1669425799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1386748770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4566 COPPERFIELD DR",
"city": "HAMBURG",
"state": "NY",
"postal_code": "14075",
"telephone_number": "716-648-1235",
"fax_number": "716-646-0853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6091 S PARK AVE",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140753734",
"telephone_number": "716-649-5789",
"fax_number": "716-646-0853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITARRESI",
"first_name": "JOHN",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "007944-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01018859",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.