Active NPI
Greg Robert Streblow, PT MPS
- Physical Therapist
- Cortland, NY
National Provider Identifier
1669563102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0201811
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02140247 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0201811 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goldwyn & Boyland Physical Therapy PC | Physical Therapist | Current | 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.
-
- Physical Therapist
- Cortland, NY
- NPI 1659576296
NY, Physical Therapist
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.