Mallory Petrus

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1207072 Issued in TX

Practice address

6584 E Road Ext
Lowville, NY 13367-1544

Phone

(315) 783-4929

NPI assigned

Jun 24, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body Mechanix Physical Therapy PLLCGroup PAC ID 8022064393, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Body Mechanix Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Lockport, NY
  • NPI 1063517662

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Western New York Physical and Occupational Therapy Group PLLC

  • Physical Therapist
  • Depew, NY
  • NPI 1881647261
  NPD (past)

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1467748731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 SNYDER DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140949497",
            "telephone_number": "315-783-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6584 E ROAD EXT",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133671544",
            "telephone_number": "315-783-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUS",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1207072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pco PC
• Lisa M Peebles
• Nicholas Peter James Perry, M.D.
• Bobbi Petranchuk, LCSW
• Allyson Petrus
• Amy Phair, FNP
• Martha Lynn Pisaniello, M.D.
• Marilyn A Planck Yancey
• Anna Platz
• Molly Pleskach, FNP

• Physical Therapist in Lowville, NY
• Providers in Lowville, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.