Individual provider Active NPI

Teresa Eagan, PT

  • Physical Therapist
  • Orchard Park, NY
National Provider Identifier
1588702013
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8579 Issued in NY
Practice address
4 Centre Dr Ste G
Orchard Park, NY 14127-4117
Phone
(716) 662-2922
Fax
(716) 662-3828
NPI assigned
Feb 5, 2007
Last updated
Mar 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 8579 NY Primary

Addresses

Primary practice location

4 Centre Dr Ste G
Orchard Park, NY 14127-4117

Mailing address

4 Centre Dr Ste G
Orchard Park, NY 14127-4117
Phone (716) 662-2922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111021000368 NY Practitioner - Physical Therapist in Private Practice 4284807074 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8579NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Duchscherer Physical Therapy, PLLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
T&M Physical Therapy PLLC Dba Lake Erie Physical Therapy Physical Therapist PastSince Feb 1, 2024 Accepting new patients

Locations

4 Centre Dr
Ste G
Orchard Park, NY 14127
Phone (716) 662-2922

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, 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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1588702013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CENTRE DR STE G",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141274117",
            "telephone_number": "716-662-2922",
            "fax_number": "716-662-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CENTRE DR STE G",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141274117",
            "telephone_number": "716-662-2922",
            "fax_number": "716-662-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGAN",
        "first_name": "TERESA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "8579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2022; 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.