Christopher Vanfleet, PT

Individual provider Active NPI Physical Therapist · Wolcott, NY

NPI 1417492802 · NPPES record last updated May 14, 2024

Key facts

NPI
1417492802
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
041063-01 (NY)
Practice address
12050 Mill St
Wolcott, NY 14590-1228
Phone
(315) 905-4155
Fax
(315) 905-4312
NPI assigned
Dec 21, 2016
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12050 Mill St
Wolcott, NY 14590-1228
Phone (315) 905-4155

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170201000684 NY Practitioner - Physical Therapist in Private Practice 0143503938 Reassigns benefits to 1 organization
Practice locations: Wolcott, NY

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
041063-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanfleet Physical Therapy, PLLC Current
since Jun 22, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 041063-01 NY Yes

Addresses

Primary practice location

12050 Mill St
Wolcott, NY 14590-1228

Mailing address

12050 Mill St
Wolcott, NY 14590-1228
Phone (315) 905-4155

Other providers in Wolcott, NY

All providers in Wolcott, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.