Individual provider Active NPI

Adrien W Reidy, PT, DPT

  • Physical Therapist
  • Rochester, NY
National Provider Identifier
1497904791
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021761 Issued in NY
Practice address
40 Stace St Ste F
Rochester, NY 14612-5557
Phone
(585) 270-0606
Fax
(585) 535-6135
NPI assigned
Sep 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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 021761 NY Primary

Addresses

Primary practice location

40 Stace St Ste F
Rochester, NY 14612-5557

Mailing address

15 Glencross Cir
Rochester, NY 14626-4460
Phone (585) 319-4493

Other practice location 1

100 Groton Pkwy
Rochester, NY 14623-4540
Phone (585) 359-3710

Other practice location 2

6524 Matthew Dr
Lockport, NY 14094-9472
Phone (716) 434-5787

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
021761NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1497904791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GLENCROSS CIR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264460",
            "telephone_number": "585-319-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 STACE ST STE F",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146125557",
            "telephone_number": "585-270-0606",
            "fax_number": "585-535-6135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Groton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146234540",
            "country_code": "US",
            "telephone_number": "585-359-3710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6524 Matthew Dr",
            "address_purpose": "LOCATION",
            "city": "Lockport",
            "state": "NY",
            "postal_code": "140949472",
            "country_code": "US",
            "telephone_number": "716-434-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIDY",
        "first_name": "ADRIEN",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.