Individual provider Active NPI

Sarah Hynes Smith, PT

  • Physical Therapist
  • Watertown, NY
National Provider Identifier
1013105675
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028940 Issued in NY
Practice address
20104 State Route 3
Watertown, NY 13601-5560
Phone
(315) 779-7100
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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 028940 NY Primary

Addresses

Primary practice location

20104 State Route 3
Watertown, NY 13601-5560

Mailing address

723 Superior St
Watertown, NY 13601-1233
Phone (315) 412-9047

Other practice location 1

573 S Main St
Central Square, NY 13036-9785
Phone (315) 676-3826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028940NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole Derue Physical Therapy P.C. PastSince Sep 20, 2007 Accepting new patients
Michael P McGee Physical Therapy PC Physical Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1013105675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 SUPERIOR ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011233",
            "telephone_number": "315-412-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20104 STATE ROUTE 3",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015560",
            "telephone_number": "315-779-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "573 S Main St",
            "address_purpose": "LOCATION",
            "city": "Central Square",
            "state": "NY",
            "postal_code": "130369785",
            "country_code": "US",
            "telephone_number": "315-676-3826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SARAH",
        "middle_name": "HYNES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.