NPIMap

Organization Active NPI

Green Room Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Troy, NY
National Provider Identifier
1083154132
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
030379-1 Issued in NY
Legal business name
GREEN ROOM PHYSICAL THERAPY PLLC
Practice address
16 N Greenbush Rd Ste 203
Troy, NY 12180-8581
Phone
(518) 477-3515
Fax
(518) 776-1070
NPI assigned
Mar 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ashley Bertorelli, PT, DPTNPI 1063956688
Title
Owner/Doctor of Physical Therapy
Phone
(518) 477-3515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X
Physical Therapy Clinic/Center 261QP2000X 030379-1 NY Primary

Addresses

Primary practice location

16 N Greenbush Rd Ste 203
Troy, NY 12180-8581

Mailing address

88 Firetower Rd
Stephentown, NY 12169-1809
Phone (518) 477-3515

Other practice location 1

1 Bell Tower Dr
Watervliet, NY 12189-2333
Phone (518) 326-3771

Other practice location 2

5 Wall St Ste 101
Clifton Park, NY 12065-3851
Phone (518) 280-2185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210216001798 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2668887100 Receives reassigned benefits from 11 practitioners
Practice locations: Ballston Lake, NY; Troy, NY; Watervliet, NY

National Provider Directory

National Provider Directory

Locations

315 Ushers Rd
Ste 120
Ballston Lake, NY 12019

5 Wall St
#101
Clifton Park, NY 12065
Phone (518) 280-2185

476 N Greenbush Rd
Ste 3
Rensselaer, NY 12144
Phone (518) 326-3771

16 N Greenbush Rd
Ste 203
Troy, NY 12180
Phone (518) 326-3771

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1083154132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 FIRETOWER RD",
            "city": "STEPHENTOWN",
            "state": "NY",
            "postal_code": "121691809",
            "telephone_number": "518-477-3515",
            "fax_number": "518-776-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N GREENBUSH RD STE 203",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121808581",
            "telephone_number": "518-477-3515",
            "fax_number": "518-776-1070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bell Tower Dr",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "NY",
            "postal_code": "121892333",
            "country_code": "US",
            "telephone_number": "518-326-3771",
            "fax_number": "518-776-1070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Wall St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653851",
            "country_code": "US",
            "telephone_number": "518-280-2185",
            "fax_number": "518-776-1070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREEN ROOM PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "BERTORELLI",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF PHYSICAL THERAPY",
        "authorized_official_telephone_number": "518-477-3515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "030379-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.