Active NPI
Julie Fellows, PT, DPT
- Physical Therapist
- Buffalo, NY
National Provider Identifier
1689955130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 033967
- Practice address
- 462 Grider Street
Buffalo, NY 14215 - Phone
- (716) 898-3895
- Fax
- (813) 633-9890
- NPI assigned
- Aug 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 26762 | FL | |
| Physical Therapist | 225100000X | 033967 | NY | Primary |
Addresses
Primary practice location
462 Grider Street
Buffalo, NY 14215
Mailing address
462 Grider Street
Buffalo, NY 14215
Phone (716) 898-3895
Other names 1
- Julie Roll
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 |
|---|---|---|---|
| PT 26762 | FL | MD | Physical Therapist |
| 033967 | NY | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1689955130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "462 GRIDER STREET",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14215",
"telephone_number": "716-898-3895",
"fax_number": "813-633-9890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 GRIDER STREET",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14215",
"telephone_number": "716-898-3895",
"fax_number": "813-633-9890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELLOWS",
"first_name": "JULIE",
"name_prefix": "Mrs.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-29",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 26762",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "033967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "ROLL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.