Individual provider Active NPI

Jamie Rager Tiberi, PT

  • Physical Therapist
  • Depew, NY
National Provider Identifier
1629085253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014196 Issued in NY
Practice address
6301 Transit Rd
Depew, NY 14043-1051
Phone
(716) 684-0400
Fax
(716) 683-7028
NPI assigned
Aug 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 014196 NY Primary

Addresses

Primary practice location

6301 Transit Rd
Depew, NY 14043-1051

Mailing address

6301 Transit Rd
Depew, NY 14043-1051
Phone (716) 684-0400

Other identifiers 7

IdentifierTypeStateIssuer
000625508001OtherNYBLUE CROSS/BLUE SHIELD
6699577OtherNYGHI
000625508002OtherNMBLUE CROSS/BLUE SHIELD
827106OtherNYMANAGED PHYSICAL NETWORK
9310551OtherNYINDEPENDENT HEALTH
00011174501OtherNYUNIVERA
650017024OtherNMR/R MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007000068 NY Practitioner - Physical Therapist in Private Practice 0749314045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12399 Olean Rd
Suite B
Chaffee, NY 14030-9550
Phone (716) 496-5550

6301 Transit Rd
Depew, NY 14043-1051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14196NYMDSpecialist
014196NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Physical and Occupational Therapy Group PLLC Physical Therapist CurrentSince Aug 27, 2012 Accepting new patients
Western New York PT Group PC Physical Therapist Past Accepting new patients
Susan E Bennett PT PC PastSince Jan 1, 2006 Accepting new patients

Locations

12399 Olean Rd
Ste B
Chaffee, NY 14030
Phone (716) 496-5550

6301 Transit Rd
Depew, NY 14043
Phone (716) 684-0400

6301 Transit Rd
#A
Depew, NY 14043
Phone (716) 684-0400

Organizations & group practices 3

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629085253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140431051",
            "telephone_number": "716-684-0400",
            "fax_number": "716-683-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140431051",
            "telephone_number": "716-684-0400",
            "fax_number": "716-683-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBERI",
        "first_name": "JAMIE",
        "middle_name": "RAGER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000625508001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6699577",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000625508002",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED PHYSICAL NETWORK",
            "identifier": "827106",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "9310551",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00011174501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "650017024",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Depew, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.