Peyton Dare Notebaert – Orthopedic Physical Therapist

Key facts

NPI: 1740947142
Entity type: Individual (NPI type 1)
Primary specialty: Orthopedic Physical Therapist 2251X0800X
Practice address: 711 Park Ave
Medina, NY 14103-1078
Phone: (585) 798-4344
Fax: (585) 798-0439
NPI assigned: Nov 19, 2021
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

TND Physical Therapy P.C. Physical Therapist · Medina, NY · NPI 1538330790

Medicare reassignment Care Compare group NPD NY

Medicare Care Compare profile

Specialty: Physical Therapist in Private Practice
Education: Other, 2021
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: TND Physical Therapy P.C. (4 clinicians)

Practice addresses (Care Compare)

711 Park Ave
Medina, NY 14103-1036
Phone (585) 798-4344

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20220103001261	NY	Practitioner - Physical Therapist in Private Practice	6002207958	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
TND Physical Therapy P.C.		Current since Dec 6, 2021	Accepting new patients

Locations

711 Park Ave
Medina, NY 14103
Phone (585) 798-4344

711 Park Ave
Ste 101
Medina, NY 14103
Phone (585) 798-4344

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Orthopedic Physical Therapist	2251X0800X			Yes

Addresses

Primary practice location

711 Park Ave
Medina, NY 14103-1078

Mailing address

6219 Tonawanda Creek Rd Apt 16
Lockport, NY 14094-7903
Phone (315) 690-6730

Other providers in Medina, NY

Eric R Musial, PHARM.D
Gary Nadeau, MD
Nadia Alexandra Nava, DPT
Samantha Grace Nelson
New York Physician Medical Services, PLLC
Oak Orchard Community Health Center, Inc.
Michele R Odrobina, M.D.
Omop LLC
Orchard Manor Inc.
Orleans Community Health

All providers in Medina, NY · Orthopedic Physical Therapist in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.