Kevin J Nellis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

207 Pine St
Syracuse, NY 13210-1137

Phone

(315) 476-3175

Fax

(315) 476-0170

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peterson and Nellis Physical Therapy PCGroup PAC ID 8022007756, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peterson & Nellis Physical Therapy PC

  • Specialist
  • Syracuse, NY
  • NPI 1033291802
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1790867547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 PINE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101137",
            "telephone_number": "315-476-3175",
            "fax_number": "315-476-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 PINE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101137",
            "telephone_number": "315-476-3175",
            "fax_number": "315-476-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIS",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "8133",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillermo Negrete Arriaga, MD
• Ilyana Nehme, NP
• Neighborlyconnections LLC
• David A Neil, DPT
• Morgan Janessa Neilon, PMHNP-BC
• Brittany Danielle Nelopae, MD
• Breahna Nelson, PHARMD
• Christine Nelson, MD
• Dianna L Nelson
• Jamie Lynn Nelson, PA

• Physical Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (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.