Erson Paul Religioso III, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

018386 Issued in NY

Practice address

6029 Pinehurst CT
Lake View, NY 14085-9203

Phone

(716) 980-5686

NPI assigned

Jul 10, 2006

Last updated

Jan 11, 2017By the provider in NPPES

Sex

Male

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Western New York Physical and Occupational Therapy Group PLLC

  • Physical Therapist
  • Depew, NY
  • NPI 1881647261
  NPD (past)
• Western New York PT Group PC

  • Physical Therapist
  • Depew, NY
  • NPI 1013188341
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1881628709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 PINEHURST CT",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859203",
            "telephone_number": "716-980-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 PINEHURST CT",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859203",
            "telephone_number": "716-980-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELIGIOSO",
        "first_name": "ERSON",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02071718",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED PHYSICAL NETWORK",
            "identifier": "837712",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000626077001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "9310992",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00011174501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6699290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen M Pellicore, FNP-BC
• Amy Lynn Peterson
• Molly Caroline Pienta
• Lisa Marie Pirone, MS
• Mary A. Radens, RN
• Ashley Simmons, M.S., CCC-SLP/L
• Alyssa Marie Sinwell, LPN
• Laurie Smith, RNFA RN FIRST ASSIST
• Karen J Sparks, MS, CCC-SLP
• Colleen Swanson

• Physical Therapist in Lake View, NY
• Providers in Lake View, 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 11, 2017; 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.