Kelsey Elaine Wallach, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

042766 Issued in NY

Practice address

200 Front St
Suite D
Vestal, NY 13850

Phone

(607) 754-1776

Fax

(607) 748-5465

NPI assigned

Feb 5, 2018

Last updated

Oct 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelsey Heller Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thomas Janik Physical Therapy PCGroup PAC ID 8325933328, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.04 of 100Reported as group

Quality

85

Improvement activities

40

Cost

76.81

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thomas Janik Physical Therapy, PC

  dba Southern Tier Physical Therapy Associates PC

  • Physical Therapist
  • Vestal, NY
  • NPI 1831248798
  Medicare reassignment Care Compare group NPD
• Delaware Valley Hospital, Inc

  • Critical Access Hospital Clinic/Center
  • Walton, NY
  • NPI 1144312646
  NPD (past)
• John Todd Mansfield Physical Therapy, PC

  dba Southern Tier Physical Therapy

  • Physical Therapist
  • Vestal, NY
  • NPI 1740226273
  NPD (past)

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1093214165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FRONT ST",
            "address_2": "SUITE D",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "13850",
            "telephone_number": "607-754-1776",
            "fax_number": "607-748-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FRONT ST",
            "address_2": "SUITE D",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "13850",
            "telephone_number": "607-754-1776",
            "fax_number": "607-748-5465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Conkey Ave",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "NY",
            "postal_code": "138151756",
            "country_code": "US",
            "telephone_number": "607-337-4227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "KELSEY",
        "middle_name": "ELAINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "HELLER",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1835)
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• Jamie Leigh Walck
• Walgreen Co (Rite Aid #10799)
• Kevin Alan Wall, FNP
• Jessica Walter
• Mo Walts
• Danielle Marie Ward, DPT.
• Jennifer Wasileski, OTR/L
• Susan Marie Watrous, M.D.

• Physical Therapist in Vestal, NY
• Providers in Vestal, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.