Individual provider Active NPI

Michele L'Hommedieu, PT

  • Physical Therapist
  • Albany, NY
National Provider Identifier
1194784330
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012502-1 Issued in NY
Practice address
1367 Washington Ave
Albany, NY 12206-1069
Phone
(518) 438-7926
Fax
(518) 438-8364
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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 012502-1 NY Primary

Addresses

Primary practice location

1367 Washington Ave
Albany, NY 12206-1069

Mailing address

711 Troy Schenectady Rd
Suite 209
Latham, NY 12110-2442
Phone (518) 786-1667

Other identifiers 3

IdentifierTypeStateIssuer
01941620MedicaidNY
RB1350OtherNYMEDICARE
P01290002OtherNYRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061129000252 NY Practitioner - Physical Therapist in Private Practice 9830197862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nicolla and Associates PT and OT Services PLLCGroup PAC ID 7315836848, 28 clinicians

Practice addresses (Care Compare)

1367 Washington Ave
Suite 100
Albany, NY 12206-1043
Phone (518) 438-7926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012502-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolla and Associates, PT & OT Services, PLLC Physical Therapist CurrentSince Mar 4, 1997 Accepting new patients
Balanced Health Physical Therapy Physical Therapist CurrentSince Jun 27, 2017 Accepting new patients
Thomas Nicolla Consulting Services, PLLC Physical Therapist CurrentSince Mar 4, 1997 Accepting new patients

Locations

1367 Washington Ave
Albany, NY 12206
Phone (518) 438-7926

1367 Washington Ave
Ste 100
Albany, NY 12206
Phone (518) 438-7926

41 Arterial Plz
Gloversville, NY 12078
Phone (518) 775-9554

711 Troy Schenectady Rd
Ste 209
Latham, NY 12110
Phone (518) 786-1667

Organizations & group practices 3

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1194784330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-786-1667",
            "fax_number": "518-786-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061069",
            "telephone_number": "518-438-7926",
            "fax_number": "518-438-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "L'HOMMEDIEU",
        "first_name": "MICHELE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "012502-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01941620",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "RB1350",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01290002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.