NPIMap

Organization Active NPI

Achieve Physical Therapy, PC

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1790778983
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010239 Issued in NY
Legal business name
ACHIEVE PHYSICAL THERAPY, PC
Practice address
4700 Onondaga Blvd
Syracuse, NY 13219-3316
Phone
(315) 475-7121
Fax
(315) 475-7144
NPI assigned
Aug 24, 2005
Last updated
May 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Mr. Martin Canavan, PTNPI 1619979341
Title
Owner/Operator
Phone
(315) 475-7121

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 010239 NY Primary

Addresses

Primary practice location

4700 Onondaga Blvd
Syracuse, NY 13219-3316

Mailing address

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209000846 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0749186971 Receives reassigned benefits from 4 practitioners
Practice locations: Syracuse, NY

National Provider Directory

National Provider Directory

Locations

395 Massachusetts Ave
Acton, MA 01720
Phone (978) 263-0007

29 Hudson Rd
Ste 3350
Sudbury, MA 01776
Phone (978) 263-0007

435 Boston Post Rd
Ste 12
Sudbury, MA 01776
Phone (978) 263-0007

4654 Onondaga Blvd
Syracuse, NY 13219
Phone (315) 475-7121

Practitioners & affiliated clinicians

Practitioners 83

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.

View all 83

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1790778983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-476-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 ONONDAGA BLVD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193316",
            "telephone_number": "315-475-7121",
            "fax_number": "315-475-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACHIEVE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "CANAVAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "315-475-7121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.