Individual provider Active NPI

Kelly C Palomo, PT, DPT

  • Physical Therapist
  • Speonk, NY
National Provider Identifier
1235260233
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
028975-1 Issued in NY
Practice address
295 Montauk Highway
Speonk, NY 11972
Phone
(631) 325-3400
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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 028975-1 NY Primary

Addresses

Primary practice location

295 Montauk Highway
Speonk, NY 11972

Mailing address

34 Culver LN
East Moriches, NY 11940-1337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071008000439 NY Practitioner - Physical Therapist in Private Practice 7719072610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Speonk Physical Therapy 2 clinicians

Practice addresses (Care Compare)

295 Montauk Hwy
Suite 586
Speonk, NY 11972-2505
Phone (631) 325-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028975-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Speonk Physical Therapy Physical Therapist CurrentSince May 26, 2009 Accepting new patients
Physical Therapy Associates of Smithtown PC Physical Therapist Past Accepting new patients
New York Physical and Occupational Therapy PLLC Physical Therapist Past Accepting new patients

Locations

100 Maple Ave
Smithtown, NY 11787
Phone (631) 265-7671

Organizations & group practices 4

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1235260233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 CULVER LN",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MONTAUK HIGHWAY",
            "city": "SPEONK",
            "state": "NY",
            "postal_code": "11972",
            "telephone_number": "631-325-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMO",
        "first_name": "KELLY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028975-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Speonk, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.