Ann M Desotelle, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012083 Issued in NY

Practice address

5225 Sheridan Dr
Williamsville, NY 14221-3573

Phone

(716) 631-2626

Fax

(716) 631-2937

NPI assigned

Mar 7, 2007

Last updated

Jan 4, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northtown Physical Therapy, P.C.

  • Physical Therapist
  • Williamsville, NY
  • NPI 1003118746
  Authorized official Same address or phone

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1831220623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 SHERIDAN DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213573",
            "telephone_number": "716-631-2626",
            "fax_number": "716-631-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 SHERIDAN DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213573",
            "telephone_number": "716-631-2626",
            "fax_number": "716-631-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOTELLE",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "MS PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9305462",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "006112451",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00011173401",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Mary Deschamps, NP
• Carol J. Descutner, PH.D.
• Suzanne Marie Desfosses-Gilliam
• Julianna Desimone
• Lynn Marie Desimone, LCSW - R
• Robert T Detamble, LMT
• Jesse Erin Dewaters, NP
• Gurpreet K Dhaliwal, MD
• Vijaypaul Stanley Dhas, PHARM.D., R.PH.
• Vashita Dhir, M.D

• Physical Therapist in Williamsville, NY
• Providers in Williamsville, 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 Jan 4, 2010; 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.