Individual provider Active NPI

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  • Physical Therapist
  • Victor, NY
National Provider Identifier
1578285524
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
6534 Anthony Dr Ste C
Victor, NY 14564-1421
Phone
(585) 869-5140
NPI assigned
Sep 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 Primary

Addresses

Primary practice location

6534 Anthony Dr Ste C
Victor, NY 14564-1421

Mailing address

6534 Anthony Dr Ste C
Victor, NY 14564-1421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115001302 NY Practitioner - Physical Therapist in Private Practice 9830567387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Limitless Physical Therapy PCGroup PAC ID 5991967846, 32 clinicians

Practice addresses (Care Compare)

6534 Anthony Dr
Suite C
Victor, NY 14564-1421
Phone (585) 869-5140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Limitless Management Services, LLC CurrentSince Feb 19, 2026 Accepting new patients
Limitless Physical Therapy PC CurrentSince Oct 12, 2022 Accepting new patients

Locations

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

6534 Anthony Dr
Ste C
Victor, NY 14564
Phone (585) 869-5140

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1578285524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6534 ANTHONY DR STE C",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6534 ANTHONY DR STE C",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641421",
            "telephone_number": "585-869-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARROW",
        "first_name": "SEVERIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.