Individual provider Active NPI

Elizabeth A Yates Horton, DPT

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1891950002
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030509-1 Issued in NY
Practice address
103 Crawford Ave
Syracuse, NY 13224-1709
Phone
(716) 868-1114
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 030509-1 NY Primary

Addresses

Primary practice location

103 Crawford Ave
Syracuse, NY 13224-1709

Mailing address

103 Crawford Ave
Syracuse, NY 13224-1709
Phone (716) 868-1114

Other identifiers 3

IdentifierTypeStateIssuer
23424OtherMDMARYLAND BOARD OF PHYSICAL THERAPY
030509-1OtherNYNEW YORK STATE LICENSE NUMBER
871186OtherDCDC HEALTH LICENSING ADMINISTRATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170407001294 NY Practitioner - Physical Therapist in Private Practice 0749566677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Engage PT OT and SLPGroup PAC ID 0143645192, 12 clinicians

Practice addresses (Care Compare)

3175 E Genesee St
Suite 5
Syracuse, NY 13224-1613
Phone (716) 868-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030509-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Engage PT OT and SLP Physical Therapist CurrentSince Jul 16, 2020 Accepting new patients
Neuro Fit PT and SLP PLLC Physical Therapist PastSince Jan 26, 2020 Accepting new patients

Locations

3175 E Genesee St
Ste 5
Syracuse, NY 13224
Phone (315) 251-2612

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1891950002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CRAWFORD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241709",
            "telephone_number": "716-868-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CRAWFORD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241709",
            "telephone_number": "716-868-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES HORTON",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030509-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF PHYSICAL THERAPY",
            "identifier": "23424",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE NUMBER",
            "identifier": "030509-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC HEALTH LICENSING ADMINISTRATION",
            "identifier": "871186",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.