Active NPI
Mitzi J Bailey, PTA
- Physical Therapy Assistant
- Buffalo, NY
National Provider Identifier
1629388392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 003764-1
- Practice address
- 346 Delaware Ave
Buffalo, NY 14202-1804 - Phone
- (716) 961-4520
- NPI assigned
- Oct 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 003764-1 | NY | Primary |
Addresses
Primary practice location
346 Delaware Ave
Buffalo, NY 14202-1804
Mailing address
346 Delaware Ave.
Buffalo, NY 14202
Phone (716) 856-7500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003764-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1629388392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "346 DELAWARE AVE.",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14202",
"telephone_number": "716-856-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "346 DELAWARE AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142021804",
"telephone_number": "716-961-4520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "MITZI",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "003764-1",
"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 Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.