Individual provider Active NPI

Greg Robert Streblow, PT MPS

  • Physical Therapist
  • Cortland, NY
National Provider Identifier
1669563102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0201811 Issued in NY
Practice address
274 Tompkins Street
Cortland, NY 13045
Phone
(607) 756-9886
Fax
(607) 756-8939
NPI assigned
Sep 28, 2006
Sex
Male
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 0201811 NY Primary

Addresses

Primary practice location

274 Tompkins Street
Cortland, NY 13045

Mailing address

274 Tompkins Street
Cortland, NY 13045
Phone (607) 756-9886

Other identifiers 1

IdentifierTypeStateIssuer
02140247MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111228000014 NY Practitioner - Physical Therapist in Private Practice 3971779836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goldwyn and Boyland Physical Therapy, PCGroup PAC ID 7113907064, 5 clinicians

Practice addresses (Care Compare)

274 Tompkins St
Cortland, NY 13045-3455
Phone (607) 756-9886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0201811NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Goldwyn & Boyland Physical Therapy PC Physical Therapist CurrentSince Jun 19, 2017 Accepting new patients

Locations

1105 State Route 13
Cortland, NY 13045
Phone (607) 756-9886

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669563102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 TOMPKINS STREET",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-756-9886",
            "fax_number": "607-756-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 TOMPKINS STREET",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-756-9886",
            "fax_number": "607-756-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREBLOW",
        "first_name": "GREG",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PT MPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0201811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02140247",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, 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.