Active NPI
Sean Michael Tyrell, DPT
- Physical Therapist
- Canandaigua, NY
National Provider Identifier
1407528532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 047796
- Practice address
- 229 Parrish St Ste 220
Canandaigua, NY 14424-1791 - Phone
- (585) 394-3920
- Fax
- (585) 394-3997
- NPI assigned
- Sep 28, 2021
- 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 | 047796 | NY | Primary |
Addresses
Primary practice location
229 Parrish St Ste 220
Canandaigua, NY 14424-1791
Mailing address
229 Parrish St Ste 220
Canandaigua, NY 14424-1791
Phone (585) 394-3920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220419001962 | NY | Practitioner - Physical Therapist in Private Practice | 0547651861 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047796 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1407528532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 PARRISH ST STE 220",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144241791",
"telephone_number": "585-394-3920",
"fax_number": "585-394-3997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 PARRISH ST STE 220",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144241791",
"telephone_number": "585-394-3920",
"fax_number": "585-394-3997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYRELL",
"first_name": "SEAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-28",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "047796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.