Theodore Boyle, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

047833 Issued in NY

Practice address

124 US Route 11
Central Square, NY 13036-9760

Phone

(315) 668-0123

NPI assigned

Oct 17, 2021

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

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.

• Rebound Sports and Orthopedic Physical Therapy, P.C.

  • Physical Therapist
  • Marcellus, NY
  • NPI 1952467177

  NY, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634428800000",
    "number": "1558024588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 FAYETTEVILLE MANLIUS RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041028",
            "telephone_number": "315-706-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 US ROUTE 11",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130369760",
            "telephone_number": "315-668-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "THEODORE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-17",
        "last_updated": "2021-10-17",
        "certification_date": "2021-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Barber
• Virginia L Boak Glahn, LMHC
• Leslee Boissy-Weatherup, DDS
• Debbie J Boland, LPN
• Kerstin L Bourgeois, LPN
• Bridget a Frio OD PC
• Nicole M Broadwell
• Allison Amy Bronner
• Rita Marie Burton, LPN
• Olessia Xenia Butenko, OD

• Physical Therapist in Central Square, NY
• Providers in Central Square, 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 Oct 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.