Active NPI
Tracy Lee Disanto, PT
- Physical Therapist
- Lyons, NY
National Provider Identifier
1659652535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 020266
- Practice address
- 98 William St
Lyons, NY 14489-1550 - Phone
- (315) 946-2200
- NPI assigned
- Sep 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225100000X | 020266 | NY | Primary |
Addresses
Primary practice location
98 William St
Lyons, NY 14489-1550
Mailing address
12895 Messner Rd
Savannah, NY 13146-9809
Phone (315) 365-3362
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 |
|---|---|---|---|
| 020266 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315267200000",
"number": "1659652535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12895 MESSNER RD",
"city": "SAVANNAH",
"state": "NY",
"postal_code": "131469809",
"telephone_number": "315-365-3362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 WILLIAM ST",
"city": "LYONS",
"state": "NY",
"postal_code": "144891550",
"telephone_number": "315-946-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISANTO",
"first_name": "TRACY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2011-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "020266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyons, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.