Active NPI
Maryssa K Diflavio Merlino, PT DPT
- Physical Therapist
- Buffalo, NY
National Provider Identifier
1710467295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 043238
- Practice address
- 95 John Muir Dr
Buffalo, NY 14228-1144 - Phone
- (716) 250-4137
- NPI assigned
- Aug 15, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 043238 | NY | Primary |
Addresses
Primary practice location
95 John Muir Dr
Buffalo, NY 14228-1144
Mailing address
3651 Delilah LN
Hamburg, NY 14075-2831
Phone (716) 931-2201
Other practice location 1
4635 Union Rd
Cheektowaga, NY 14225-1851
Phone (716) 505-5700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043238 | Other | NY | NYS PHYSICAL THERAPIST LICENSE |
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 |
|---|---|---|---|
| 043238 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Wny | Past | Accepting new patients | |
| Aspire Wny | Past | Accepting new patients |
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.
-
- Early Intervention Provider Agency
- Cheektowaga, NY
- NPI 1386905115
-
- Early Intervention Provider Agency
- Cheektowaga, NY
- NPI 1790031201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1710467295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3651 DELILAH LN",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140752831",
"telephone_number": "716-931-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 JOHN MUIR DR",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142281144",
"telephone_number": "716-250-4137"
}
],
"practiceLocations": [
{
"address_1": "4635 Union Rd",
"address_purpose": "LOCATION",
"city": "Cheektowaga",
"state": "NY",
"postal_code": "142251851",
"country_code": "US",
"telephone_number": "716-505-5700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIFLAVIO MERLINO",
"first_name": "MARYSSA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PT DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "043238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS PHYSICAL THERAPIST LICENSE",
"identifier": "043238",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}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 Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.