Theresa Intilli Klausner, MS, APRN, BC, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F333567-1 Issued in NY

Practice address

4104 State Highway 30
Amsterdam, NY 12010-6202

Phone

(518) 883-8620

Fax

(518) 883-5653

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

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.

• Nathan Littauer Hospital Association

  • Skilled Nursing Facility
  • Gloversville, NY
  • NPI 1073541850
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1265587117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST STATE STREET",
            "address_2": "PO BOX 1250",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120780010",
            "telephone_number": "518-775-4205",
            "fax_number": "518-775-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120106202",
            "telephone_number": "518-883-8620",
            "fax_number": "518-883-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAUSNER",
        "first_name": "THERESA",
        "middle_name": "INTILLI",
        "name_prefix": "Mrs.",
        "credential": "MS, APRN, BC, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333567-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "F333567-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Elizabeth Kennedy, PT, DPT
• Mahmood A Khan, M.D., M.B.B.S,
• King Mental Health Counseling, PLLC
• Stephanie Lee Kinney, LMSW
• Kathleen Kissinger, FNP
• Nicole Lyn Klym, MS CCC-SLP
• Ashley Knowlton, FNP
• Nancy S Knudsen, MD
• Kurt M Konieczny, M.D.
• Sherri Korona, MS ED

• Family Nurse Practitioner in Amsterdam, NY
• Providers in Amsterdam, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.