Individual provider Active NPI

Stacie E Latray, PT

  • Physical Therapist
  • Rochester, NY
National Provider Identifier
1649529744
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035512-1 Issued in NY
Practice address
1850 Buffalo Rd Ste 200
Rochester, NY 14624-1550
Phone
(585) 420-7402
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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 035512-1 NY Primary

Addresses

Primary practice location

1850 Buffalo Rd Ste 200
Rochester, NY 14624-1550

Mailing address

1850 Buffalo Rd Ste 200
Rochester, NY 14624-1550
Phone (585) 420-7402

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

LicenseStateTypeSpecialty
035512-1NYMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1649529744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BUFFALO RD STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241550",
            "telephone_number": "585-420-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BUFFALO RD STE 200",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241550",
            "telephone_number": "585-420-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATRAY",
        "first_name": "STACIE",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035512-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.