NPIMap

Organization Active NPI

Western New York Fitness Rehabilitation, PT, PLLC

  • Physical Therapy Clinic/Center
  • West Seneca, NY
National Provider Identifier
1891391199
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
WESTERN NEW YORK FITNESS REHABILITATION, PT, PLLC
Practice address
425 Meyer Rd
West Seneca, NY 14224-1954
Phone
(716) 563-4811
NPI assigned
Dec 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Dr. Daniel R Keller, DPTNPI 1376970806
Title
Member
Phone
(716) 563-4811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

425 Meyer Rd
West Seneca, NY 14224-1954

Mailing address

425 Meyer Rd
West Seneca, NY 14224-1954
Phone (716) 563-4811

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL wnyphysicaltherapy716@gmail.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211001000239 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4082011275 Receives reassigned benefits from 13 practitioners
Practice locations: West Seneca, NY; East Amherst, NY

National Provider Directory

National Provider Directory
Tax ID family
Western New York Fitness Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

425 Meyer Rd
West Seneca, NY 14224
Phone (716) 563-4811

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1891391199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MEYER RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241954",
            "telephone_number": "716-563-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MEYER RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241954",
            "telephone_number": "716-563-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEW YORK FITNESS REHABILITATION, PT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "716-563-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wnyphysicaltherapy716@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "West Seneca",
            "address_1": "425 Meyer Rd",
            "city": "West Seneca",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142241954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.