Annelise Modica, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

044925 Issued in NY

Practice address

3767 Delaware Ave
Buffalo, NY 14217-1040

Phone

(716) 874-6175

Fax

(716) 874-6175

NPI assigned

Oct 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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.

• Buffalo Rehab Group Physical Therapy and Occupational Therapy PC

  • Physical Therapist
  • West Seneca, NY
  • NPI 1548290943
  Medicare reassignment NPD
• Associated Physical & Occupational Therapists, PLLC

  • Occupational Therapist
  • Kenmore, NY
  • NPI 1538378039

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1811539315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3767 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142171040",
            "telephone_number": "716-874-6175",
            "fax_number": "716-874-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142171040",
            "telephone_number": "716-874-6175",
            "fax_number": "716-874-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODICA",
        "first_name": "ANNELISE",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05909820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mobile Telemedicine Ny PC
• Sandra Mobley-Terry, CASAC
• Madeline Claire Mocarski, PHARMD
• Timothy Mochrie, BSW
• Elizabeth Marie Moden, DC
• Joseph Samuel Modica, MD
• Kevin Modlmayer
• Moe'S Transportation, Inc.
• Moeen Abu-Sitta, M.D. P.C.
• Jane Elizabeth Moeller

• Physical Therapist in Buffalo, NY
• Providers in Buffalo, 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 Sep 3, 2024; 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.