Individual provider Active NPI

Mallory Ann Rolewicz, DPT

  • Physical Therapist
  • Cortland, NY
National Provider Identifier
1508745415
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054796 Issued in NY
Practice address
165 Main St Ste 5a
Cortland, NY 13045-3049
Phone
(607) 408-5200
Fax
(585) 869-5142
NPI assigned
Aug 27, 2025
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 054796 NY Primary

Addresses

Primary practice location

165 Main St Ste 5a
Cortland, NY 13045-3049

Mailing address

2561 Lac de Ville Blvd Ste 100
Rochester, NY 14618-5645
Phone (585) 869-5140

Other practice location 1

242 Port Watson St
Cortland, NY 13045-2823
Phone (607) 758-7212

Other names 1

  • Mallory Ann Cobb Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908003700 NY Practitioner - Physical Therapist in Private Practice 2365944329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Limitless Physical Therapy PCGroup PAC ID 5991967846, 32 clinicians
Fadden and Associates Physical Therapy, PLLCGroup PAC ID 8527121425, 5 clinicians

Practice addresses (Care Compare)

165 Main St
Suite 5a
Cortland, NY 13045-3049
Phone (607) 408-5200

242 Port Watson St
Cortland, NY 13045-2823
Phone (607) 758-7212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054796NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Limitless Physical Therapy PC CurrentSince Apr 27, 2026 Accepting new patients
Fadden & Associates Physical Therapy PLLC Physical Therapist CurrentSince Aug 28, 2025 Accepting new patients
Limitless Management Services, LLC PastSince Apr 27, 2026 Accepting new patients

Locations

242 Port Watson St
Cortland, NY 13045
Phone (607) 758-7212

2561 Lac de Ville Blvd
Ste 100
Rochester, NY 14618
Phone (585) 473-1290

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1508745415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 LAC DE VILLE BLVD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185645",
            "telephone_number": "585-869-5140",
            "fax_number": "585-869-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST STE 5A",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130453049",
            "telephone_number": "607-408-5200",
            "fax_number": "585-869-5142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Port Watson St",
            "address_purpose": "LOCATION",
            "city": "Cortland",
            "state": "NY",
            "postal_code": "130452823",
            "country_code": "US",
            "telephone_number": "607-758-7212",
            "fax_number": "607-758-3416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLEWICZ",
        "first_name": "MALLORY",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "COBB",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.