Active NPI
Mary Therese Novak, PT
- Physical Therapist
- Webster, NY
National Provider Identifier
1780672444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0090831
- Practice address
- 2000 Empire Blvd
Building #2
Webster, NY 14580-1957 - Phone
- (585) 671-1030
- NPI assigned
- Oct 7, 2005
- Last updated
- Dec 5, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0090831 | NY | Primary |
Addresses
Primary practice location
2000 Empire Blvd
Building #2
Webster, NY 14580-1957
Mailing address
131 Mill Rd
Pittsford, NY 14534-3274
Phone (585) 586-3227
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0090831 | NY | MD | Occupational Therapist |
| 009083 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1780672444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 MILL RD",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "145343274",
"telephone_number": "585-586-3227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 EMPIRE BLVD",
"address_2": "BUILDING #2",
"city": "WEBSTER",
"state": "NY",
"postal_code": "145801957",
"telephone_number": "585-671-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK",
"first_name": "MARY THERESE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-07",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0090831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Webster, NY
- New York Dialysis Services, Inc. (FMS - Southern Manhattan Dialysis Center (Monroe County))
- Rebecca Nicastro, DPT
- Anna E Nikitkova
- Northeast Quadrant Advanced Life Support Inc
- Murray A. Notebaert
- Sharon Joan Nowack
- Ramona Nowak, RN,RD,CDE,CDN
- Andrea C Nuccio, REGISTERED PROFESSIO
- Nicole Nudd, RN
- Norman O Dell
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.