Michael George Donnelly Jr., PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045486 Issued in NY

Practice address

2 Delavergne Ave
Wappingers Falls, NY 12590-1202

Phone

(845) 297-4789

Fax

(856) 297-8596

NPI assigned

Feb 4, 2020

Last updated

Feb 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proclinix Sports Physical Therapy Chiropractic Wellness,PLLCGroup PAC ID 2466581301, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Proclinix Sports Physical Therapy Chiropractic Wellness,PLLC

  • Physical Therapist
  • Armonk, NY
  • NPI 1114132511
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1912539321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DELAVERGNE AVE",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901202",
            "telephone_number": "845-297-4789",
            "fax_number": "856-297-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DELAVERGNE AVE",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901202",
            "telephone_number": "845-297-4789",
            "fax_number": "856-297-8596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3399 North Rd",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126011387",
            "country_code": "US",
            "telephone_number": "845-297-4789",
            "fax_number": "845-297-8596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4353 Albany Post Rd",
            "address_purpose": "LOCATION",
            "city": "Hyde Park",
            "state": "NY",
            "postal_code": "125383604",
            "country_code": "US",
            "telephone_number": "845-233-4960",
            "fax_number": "845-233-4961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAMPILII-SNYDER PHYSICAL THERAPY PC",
            "identifier": "1184655672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Wappingers Falls, NY
• Providers in Wappingers Falls, 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 Feb 4, 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.