Organization Active NPI

Active Physical Therapy Solutions PC

  • Physical Therapist
  • Auburn, NY
National Provider Identifier
1780823807
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028390 Issued in NY
Legal business name
ACTIVE PHYSICAL THERAPY SOLUTIONS PC
Practice address
40 W Lake Ave
Auburn, NY 13021-3724
Phone
(315) 515-3117
Fax
(315) 515-3121
NPI assigned
Feb 12, 2009
Last updated
May 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Authorized official

Name
Dale J Buchberger, PTNPI 1407865280
Title
Owner
Phone
(315) 515-3117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008418 NY
Physical Therapist 225100000X 028390 NY Primary

Addresses

Primary practice location

40 W Lake Ave
Auburn, NY 13021-3724

Mailing address

4567 Crossroads Park Dr
Liverpool, NY 13088-3589
Phone (315) 295-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090415000053 NY Part B Supplier - Clinic/Group Practice 3971650615 Receives reassigned benefits from 3 practitioners
Practice locations: Auburn, NY

National Provider Directory

National Provider Directory

Locations

40 Westlake Ave
Auburn, NY 13021
Phone (315) 515-3117

91 Columbus St
Auburn, NY 13021
Phone (315) 255-3944

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1780823807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W LAKE AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213724",
            "telephone_number": "315-515-3117",
            "fax_number": "315-515-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE PHYSICAL THERAPY SOLUTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "BUCHBERGER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-515-3117",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008418",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; 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.