Individual provider Active NPI

Georgia Rose Dailey, PT, DPT

  • Physical Therapist
  • Buffalo, NY
National Provider Identifier
1619709383
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
052572 Issued in NY
Practice address
2420 Sweet Home Rd
Buffalo, NY 14228-2243
Phone
(716) 525-1184
NPI assigned
Aug 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 052572 NY Primary

Addresses

Primary practice location

2420 Sweet Home Rd
Buffalo, NY 14228-2243

Mailing address

111 Brandywine Dr
Williamsville, NY 14221-1876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250108002400 NY Practitioner - Physical Therapist in Private Practice 1557899226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Gravino and Brown Physical Therapy, PLLCGroup PAC ID 7315350048, 7 clinicians

Practice addresses (Care Compare)

2420 Sweet Home Rd
Suite 130
Amherst, NY 14228-2243
Phone (716) 525-1184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052572NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gravino & Brown Physical Therapy, PLLC CurrentSince Oct 27, 2024 Accepting new patients

Locations

2420 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 525-1184

2420 Sweet Home Rd
Ste 130
Buffalo, NY 14228
Phone (716) 525-1184

Organizations & group practices 1

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": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1619709383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BRANDYWINE DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 SWEET HOME RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142282243",
            "telephone_number": "716-525-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAILEY",
        "first_name": "GEORGIA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.