William Rodolfo Pena, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0166341 Issued in NY

Practice address

19 Hodskin St
Ste 1
Canton, NY 13617-1175

Phone

(315) 379-0992

Fax

(315) 379-0993

NPI assigned

Dec 28, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

• Core Access Therapies Inc

  • Physical Therapist
  • Canton, NY
  • NPI 1669036463
  NPD Authorized official

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1811974082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HODSKIN ST",
            "address_2": "STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171175",
            "telephone_number": "315-379-0992",
            "fax_number": "315-379-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HODSKIN ST",
            "address_2": "STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171175",
            "telephone_number": "315-379-0992",
            "fax_number": "315-379-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "WILLIAM",
        "middle_name": "RODOLFO",
        "name_prefix": "Dr.",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0166341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02163660",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Ann Parsons, PT, CLT, DPT
• Timothy Parsons, PT
• Sunny Patel, MD
• Thushyanthan Pathmalingam
• Megan Pebbles, OTR/L
• Adria E Pennington-Lee, RN
• Camille Leanne Perkins, PHYSICIAN ASSISTANT
• Lynn Marie Perkins, P.T.
• Luc Perrier, M.D.
• Personal Journeys Counseling

• Physical Therapist in Canton, NY
• Providers in Canton, 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 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.