Individual provider Active NPI

Jessica Myles, MPT

  • Physical Therapist
  • Saratoga Springs, NY
National Provider Identifier
1023783602
Registry record updated Aug 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029318 Issued in NY
Practice address
131 Lawrence St
Saratoga Springs, NY 12866-1346
Phone
(518) 587-4100
NPI assigned
Aug 15, 2021
Last updated
Aug 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2021

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 029318 NY Primary

Addresses

Primary practice location

131 Lawrence St
Saratoga Springs, NY 12866-1346

Mailing address

201 Old Post Rd
Ballston Spa, NY 12020-4001
Phone (518) 867-6566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917000548 NY Practitioner - Physical Therapist in Private Practice 9830596824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

71 Longview Dr
Queensbury, NY 12804-5936
Phone (518) 832-7875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029318NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PRN Physical, Occupational and Speech Therapy Network, PLLC Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

20 Peachtree Ct
Ste 105
Holbrook, NY 11741
Phone (518) 253-4983

131 Lawrence St
Saratoga Springs, NY 12866
Phone (518) 587-3600

2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628985600000",
    "number": "1023783602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OLD POST RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120204001",
            "telephone_number": "518-867-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LAWRENCE ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661346",
            "telephone_number": "518-587-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "JESSICA",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-15",
        "last_updated": "2021-08-15",
        "certification_date": "2021-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2021; 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.