Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Taillie, PT

Individual provider Physical Therapist · NPI 1528730348

Benjamin Taillie, PT is a Physical Therapist in Private Practice in Brockport, New York. Qualified in 2023, 3 years ago. Practices with Agape Physical Therapy Services, PC, a 23-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2021
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

92 W Ave
Brockport, NY 14420-1306
Phone: (585) 637-0790
Fax: (585) 637-3572
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Physical Therapist Taxonomy 225100000X · Licence PT301094 (CA)

Record details

NPI number1528730348
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedSeptember 30, 2021
Last updated in NPPESNovember 28, 2023
Certification dateNovember 28, 2023
Mailing address92 West Ave, Brockport, NY 14420-1306

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Agape Physical Therapy Services, Pc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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