Michelle Ann Jimerson, D.P.T
Individual provider Active NPI Physical Therapist · Irving, NY
NPI 1982058749 · NPPES record last updated Sep 15, 2025
Key facts
- NPI
- 1982058749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 039312 (NY)
- Practice address
- 275 Thomas Indian School Dr
Irving, NY 14081-9341 - Phone
- (716) 532-5582
- Fax
- (716) 242-6344
- NPI assigned
- Apr 19, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211108001163 | NY | Practitioner - Physical Therapist in Private Practice | 6406245711 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039312 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Nation of Indians | Current |
Accepting new patients | |
| Seneca Nation of Indians | Current |
Accepting new patients |
Locations
275 Thomas Indian School Dr
Irving, NY 14081
Phone (716) 532-5582
987 R C Hoag Dr
Salamanca, NY 14779
Phone (716) 945-5894
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 039312 | NY | Yes |
Addresses
Primary practice location
275 Thomas Indian School Dr
Irving, NY 14081-9341
Mailing address
987 R C Hoag Dr
Salamanca, NY 14779-1365
Phone (716) 945-5894
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06899334 | Medicaid | NY |
Other providers in Irving, NY
- Laura Lee Hartinger
- Haley Starr Hiller
- Natalie Anne Hobbs
- Jacqueline Carol Rogers
- Jocelyn Mary Jarosz
- Michael Johnson
- Karen Elizabeth Kaminski
- Jacqueline Karstedt
- Heidi Lynne Kazmark
- Jason Christopher Kloc
All providers in Irving, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.