Individual provider Active NPI

Brian Burns, PT, DPT, ATC

  • Physical Medicine & Rehabilitation Physician
  • Ithaca, NY
National Provider Identifier
1679170682
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
046328 Issued in NY
Practice address
2359 N Triphammer Rd
Ithaca, NY 14850-1059
Phone
(607) 257-5009
Fax
(607) 257-9985
NPI assigned
Oct 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 046328 NY Primary

Addresses

Primary practice location

2359 N Triphammer Rd
Ithaca, NY 14850-1059

Mailing address

2359 N Triphammer Rd
Ithaca, NY 14850-1059
Phone (607) 257-5009

Other practice location 1

61 W Main St
Trumansburg, NY 14886-9574
Phone (607) 387-7400

Other practice location 2

15 Ellis Dr
Dryden, NY 13053-9630
Phone (607) 244-5653

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201215002653 NY Practitioner - Physical Therapist in Private Practice 7315359361 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046328NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reilley Physical Therapy, PLLC CurrentSince Jul 15, 2021 Accepting new patients
McCune Murphy & Potter Physical Therapy PC CurrentSince Nov 3, 2020 Accepting new patients

Locations

15 Ellis Dr
Dryden, NY 13053
Phone (607) 244-5653

2359 N Triphammer Rd
Ithaca, NY 14850
Phone (607) 257-3452

Organizations & group practices 2

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": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1679170682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2359 N TRIPHAMMER RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501059",
            "telephone_number": "607-257-5009",
            "fax_number": "607-257-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2359 N TRIPHAMMER RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501059",
            "telephone_number": "607-257-5009",
            "fax_number": "607-257-9985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 W Main St",
            "address_purpose": "LOCATION",
            "city": "Trumansburg",
            "state": "NY",
            "postal_code": "148869574",
            "country_code": "US",
            "telephone_number": "607-387-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Ellis Dr",
            "address_purpose": "LOCATION",
            "city": "Dryden",
            "state": "NY",
            "postal_code": "130539630",
            "country_code": "US",
            "telephone_number": "607-244-5653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "046328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.