Active NPI
Suzanne Marie Hake, PT
- Pediatric Physical Therapist
- Batavia, NY
National Provider Identifier
1730819202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 010165-01
- Practice address
- 2A Richmond Ave
Batavia, NY 14020-1408 - Phone
- (585) 343-5384
- NPI assigned
- Jun 16, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 010165-01 | NY | Primary |
Addresses
Primary practice location
2A Richmond Ave
Batavia, NY 14020-1408
Mailing address
2A Richmond Ave
Batavia, NY 14020-1408
Phone (585) 343-5384
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010165-01 | Other | NY | NEW YORK STATE EDUCATION DEPARTMENT |
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 |
|---|---|---|---|
| 010165-01 | NY | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655337600000",
"number": "1730819202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2A RICHMOND AVE",
"city": "BATAVIA",
"state": "NY",
"postal_code": "140201408",
"telephone_number": "585-343-5384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2A RICHMOND AVE",
"city": "BATAVIA",
"state": "NY",
"postal_code": "140201408",
"telephone_number": "585-343-5384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKE",
"first_name": "SUZANNE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-16",
"last_updated": "2022-06-16",
"certification_date": "2022-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": "NY",
"license": "010165-01",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE EDUCATION DEPARTMENT",
"identifier": "010165-01",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Batavia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.