Individual provider Active NPI

Keith Charles Fraas, PT

  • Specialist
  • Lackawanna, NY
National Provider Identifier
1841478104
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
020731-1 Issued in NY
Practice address
1025 Ridge Rd
Lackawanna, NY 14218-1755
Phone
(716) 822-4781
Fax
(716) 825-5765
NPI assigned
Feb 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 020731-1 NY Primary

Addresses

Primary practice location

1025 Ridge Rd
Lackawanna, NY 14218-1755

Mailing address

12 Creekwood Dr
Lancaster, NY 14086-9386
Phone (716) 685-8872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020731-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Childpro of Western New York Specialist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1841478104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CREEKWOOD DR",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140869386",
            "telephone_number": "716-685-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 RIDGE RD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142181755",
            "telephone_number": "716-822-4781",
            "fax_number": "716-825-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAAS",
        "first_name": "KEITH",
        "middle_name": "CHARLES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-08",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "020731-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.