Kaelyn Ragonese, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045924 Issued in NY

Practice address

465 Columbus Ave Ste 130
Valhalla, NY 10595-1376

Phone

(914) 741-2850

Fax

(914) 741-2851

NPI assigned

Jun 25, 2020

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Proactive Physical Therapy and Sports Rehabilitation PLLCGroup PAC ID 7719950120, 5 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Proactive Physical Therapy & Sports Rehabilitation, PLLC

  • Physical Therapy Clinic/Center
  • Valhalla, NY
  • NPI 1821125147
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1124645155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 COLUMBUS AVE STE 130",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951376",
            "telephone_number": "914-741-2850",
            "fax_number": "914-741-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 COLUMBUS AVE STE 130",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951376",
            "telephone_number": "914-741-2850",
            "fax_number": "914-741-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGONESE",
        "first_name": "KAELYN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasser Amr Abdelmeguid Radwan, MD
• Theodore Rafael, M.D.
• Maureen Raffa, NP
• Aryan Rafieezadeh
• Adham Ragab
• Michael Rahimi, MD
• Syed Nasimur Rahman, PHARMACIST
• Sarah Rahni
• Michelle L. Raimo
• Aiswarya Raj, MBBS

• Physical Therapist in Valhalla, NY
• Providers in Valhalla, 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 Jul 30, 2020; 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.