Individual provider Active NPI

Marilyn Klim, PT

  • Physical Therapist
  • Webster, NY
National Provider Identifier
1063857522
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024245-1 Issued in NY
Practice address
159 W Main St
Lower Level East
Webster, NY 14580-2960
Phone
(585) 872-9669
Fax
(585) 872-9449
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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 024245-1 NY Primary

Addresses

Primary practice location

159 W Main St
Lower Level East
Webster, NY 14580-2960

Mailing address

4 Castle Gate
Fairport, NY 14450-9171
Phone (585) 377-4600

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
024245-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester Physical Therapy Wellness PLLC Physical Therapist Past Accepting new patients

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1063857522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CASTLE GATE",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509171",
            "telephone_number": "585-377-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W MAIN ST",
            "address_2": "LOWER LEVEL EAST",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802960",
            "telephone_number": "585-872-9669",
            "fax_number": "585-872-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIM",
        "first_name": "MARILYN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024245-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.