716 Physical Therapy, PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036600 Issued in NY

Legal business name

716 PHYSICAL THERAPY, PLLC

Practice address

4931 Lake Shore Rd Ste 300
Hamburg, NY 14075-5662

Phone

(716) 560-3290

NPI assigned

Dec 13, 2017

Last updated

Dec 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anthony M Boergers, DPTNPI 1205232360

Title

Owner/Physical Therapist

Phone

(716) 560-3290

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Boergers

  • Physical Therapist
  • Hamburg, NY
  • NPI 1205232360
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1770098634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4591 SOUTHWESTERN BLVD APT FF4",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140757706",
            "telephone_number": "716-560-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4931 LAKE SHORE RD STE 300",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755662",
            "telephone_number": "716-560-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "716 PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "BOERGERS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "716-560-3290",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "036600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 5775 Maelou Drive Operating Company LLC (Elderwood at Hamburg)
• 5775 Maelou Drive Operating Company, LLC
• 76 Buffalo Street Operating Company LLC (Elderwood Assisted Living at Hamburg)
• Nadia Aboley
• Lori Ann Abramowitz, MS
• Linda A Abrams, LCSW-R
• Courtney Acquard, M.A.,CCC-SLP

• Physical Medicine & Rehabilitation Physician in Hamburg, NY
• Providers in Hamburg, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.