Individual provider Active NPI

Polly Ann Welch, DPT

  • Physical Therapist
  • Le Roy, NY
National Provider Identifier
1710233614
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036363 Issued in NY
Practice address
3 West Ave
Le Roy, NY 14482-1381
Phone
(585) 768-4550
Fax
(585) 768-2335
NPI assigned
Jul 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 013830 OH
Orthopedic Physical Therapist 2251X0800X 006065 KY
Physical Therapist 225100000X 036363 NY Primary

Addresses

Primary practice location

3 West Ave
Le Roy, NY 14482-1381

Mailing address

3 West Ave
Le Roy, NY 14482-1381
Phone (585) 768-4550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131202000008 NY Practitioner - Physical Therapist in Private Practice 8820248966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesee Valley Physical Therapy and Sports Rehab PCGroup PAC ID 8325029606, 35 clinicians

Practice addresses (Care Compare)

3 W Ave
Le Roy, NY 14482-1381
Phone (585) 768-4550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
036363NYMDPhysical Therapist
013830OHMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Professionals, PC Physical Therapist CurrentSince Aug 12, 2013 Accepting new patients
Genesee Valley Physical Therapy & Sports Rehab., P.C. Physical Therapist CurrentSince Jul 25, 2024 Accepting new patients

Locations

5 Alva Pl
Batavia, NY 14020
Phone (585) 343-9496

3506 Thomas Dr
Lakeville, NY 14480
Phone (585) 346-0060

3 West Ave
Le Roy, NY 14482
Phone (585) 224-5179

2300 Buffalo Rd
Bldg 300A
Rochester, NY 14624
Phone (716) 247-0080

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1710233614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WEST AVE",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821381",
            "telephone_number": "585-768-4550",
            "fax_number": "585-768-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WEST AVE",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821381",
            "telephone_number": "585-768-4550",
            "fax_number": "585-768-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "POLLY",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-28",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "013830",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KY",
            "license": "006065",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Roy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.