Individual provider Active NPI

Kimberly Silvernail Keane, PT

  • Physical Therapist
  • Albany, NY
National Provider Identifier
1013095090
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018391 Issued in NY
Practice address
314 S Manning Blvd
Albany, NY 12208-1708
Phone
(518) 453-2273
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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 018391 NY Primary

Addresses

Primary practice location

314 S Manning Blvd
Albany, NY 12208-1708

Mailing address

314 S Manning Blvd
Albany, NY 12208-1708

Other identifiers 7

IdentifierTypeStateIssuer
1044472OtherCDPHP
249402OtherMVP
040426006275OtherFIDELIS
000407413001OtherBSNENY
7203472OtherAETNA
82313OtherGHIHMO
00018391MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101005000611 NY Practitioner - Physical Therapist in Private Practice 4880886175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Disability Services, IncGroup PAC ID 5799685327, 29 clinicians

Practice addresses (Care Compare)

314 S Manning Blvd
Albany, NY 12208-1708
Phone (518) 437-5771

6141 State Farm Rd
Guilderland, NY 12084-9521
Phone (518) 437-5771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018391NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Disability Services, Inc CurrentSince Jul 1, 2002 Accepting new patients

Locations

314 S Manning Blvd
Albany, NY 12208
Phone (518) 437-5528

6141 State Farm Rd
Guilderland, NY 12084
Phone (518) 437-5771

2 Charles Blvd
Guilderland, NY 12084
Phone (518) 437-5771

Interoperability endpoints

  • Direct secure messaging: kimberly.keane.p1@direct.cfdsny.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1013095090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081708",
            "telephone_number": "518-453-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "KIMBERLY",
        "middle_name": "SILVERNAIL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "1044472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "249402",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426006275",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY",
            "identifier": "000407413001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7203472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHIHMO",
            "identifier": "82313",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018391",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.