Ethos Performance Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ETHOS PERFORMANCE REHAB LLC

Practice address

2205 Kenmore Ave Ste 108
Buffalo, NY 14207-1329

Phone

(716) 472-6267

NPI assigned

Nov 18, 2021

Organization subpart

No

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

Authorized official

Name

Matthew Veronica, DPTNPI 1174998926

Title

Owner

Phone

(716) 472-6267

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Veronica, DPT

  • Physical Therapist
  • Buffalo, NY
  • NPI 1174998926
  NPD Authorized official

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1679230395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 KENMORE AVE STE 108",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071329",
            "telephone_number": "716-472-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 KENMORE AVE STE 108",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071329",
            "telephone_number": "716-472-6267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Lockport",
            "state": "NY",
            "postal_code": "140946142",
            "country_code": "US",
            "telephone_number": "716-472-6267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ETHOS PERFORMANCE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "VERONICA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-472-6267",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Walker Essman, RPA-C
• Sol del Rosario Estrada Pena
• Richard Alan Etengoff, DDS
• Stephane Ethier, M.D.
• Ethos Performance Physical Therapy PLLC (Ethos Performance and Pelvic Physical Therapy)
• Emily Ets-Hokin, PH.D.
• Donald Kitungano Etulo
• Christine Marie Etzel, MD
• Lindsey Euscher, MD
• Mary Michael Evanco-Caryk, REGISTERED NURSE

• Physical Therapist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.