Individual provider Active NPI

Valerie Peck, PT

  • Physical Therapist
  • Central Square, NY
National Provider Identifier
1609103449
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031922-1 Issued in NY
Practice address
573 S Main St
Central Square, NY 13036-9785
Phone
(315) 676-3826
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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 031922-1 NY Primary

Addresses

Primary practice location

573 S Main St
Central Square, NY 13036-9785

Mailing address

573 S Main St
Central Square, NY 13036-9785

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200608002441 NY Practitioner - Physical Therapist in Private Practice 5193146702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onondaga Physical Therapy, LLCGroup PAC ID 8325039365, 25 clinicians

Practice addresses (Care Compare)

6800 E Genesee St
Fayetteville, NY 13066-1089
Phone (315) 635-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031922-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Onondaga Physical Therapy, LLC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Onondaga Physical Therapy Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Onondaga Physical Therapy, LLC Physical Therapist Current Accepting new patients
Onondaga Physical Therapy, LLC Physical Therapist Past Accepting new patients
Michael P McGee Physical Therapy PC Physical Therapist Past Accepting new patients
Nicole Derue Physical Therapy P.C. PastSince Sep 20, 2007 Accepting new patients

Locations

19 E Genesee St
Ste 103
Baldwinsville, NY 13027

6265 State Route 31
Cicero, NY 13039

6800 E Genesee St
Fayetteville, NY 13066
Phone (315) 446-4400

8390 Oswego Rd
Liverpool, NY 13090
Phone (315) 652-4323

7575 Buckley Rd
Syracuse, NY 13212
Phone (315) 635-0000

Organizations & group practices 6

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1609103449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "573 S MAIN ST",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130369785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 S MAIN ST",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130369785",
            "telephone_number": "315-676-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "VALERIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031922-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Square, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.