Rodd Koch, P.T.

Individual provider Active NPI Physical Therapist · Wynantskill, NY

NPI 1134423924 · NPPES record last updated Jan 7, 2011

Key facts

NPI
1134423924
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
019307-1 (NY)
Practice address
32 Francis Dr
Wynantskill, NY 12198-8781
Phone
(518) 286-9021
NPI assigned
Jan 7, 2011
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32 Francis Dr
Wynantskill, NY 12198-8781
Phone (518) 813-1629

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110623000401 NY Practitioner - Physical Therapist in Private Practice 2062690944 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
019307-1NYMDPhysical Therapist
019307NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodd Koch Physical Therapy PC Physical Therapist Current
since Feb 1, 2002
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 019307-1 NY Yes

Addresses

Primary practice location

32 Francis Dr
Wynantskill, NY 12198-8781

Mailing address

32 Francis Dr
Wynantskill, NY 12198-8781
Phone (518) 286-9021

Other providers in Wynantskill, NY

All providers in Wynantskill, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.