Active NPI
Jillian Riley
- Physical Therapist
- Rochester, NY
National Provider Identifier
1548096530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 052863
- Practice address
- 4901 Lac de Ville Blvd BLDG D
Rochester, NY 14618-5647 - Phone
- (585) 341-9200
- Fax
- (585) 320-1023
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- 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 | 052863 | NY | Primary |
Addresses
Primary practice location
4901 Lac de Ville Blvd BLDG D
Rochester, NY 14618-5647
Mailing address
111 Shoreway Dr
Rochester, NY 14612-1225
Phone (585) 472-6386
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
| License | State | Type | Specialty |
|---|---|---|---|
| 052863 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1548096530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 SHOREWAY DR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146121225",
"telephone_number": "585-472-6386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 LAC DE VILLE BLVD BLDG D",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146185647",
"telephone_number": "585-341-9200",
"fax_number": "585-320-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "JILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "052863",
"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 Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.