Individual provider Active NPI

Kathryn E Lavalley, PT MS

  • Physical Therapist
  • Plattsburgh, NY
National Provider Identifier
1275521007
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0235781 Issued in NY
Practice address
12 Booth Dr
Plattsburgh, NY 12901-6404
Phone
(518) 561-2225
Fax
(518) 561-2212
NPI assigned
Oct 6, 2005
Last updated
Oct 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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 0235781 NY Primary

Addresses

Primary practice location

12 Booth Dr
Plattsburgh, NY 12901-6404

Mailing address

12 Booth Dr
Plattsburgh, NY 12901-6404
Phone (518) 561-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041230000394 NY Practitioner - Physical Therapist in Private Practice 4082672597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 A Oak St
Plattsburgh, NY 12901-2820
Phone (518) 586-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0235781NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Insightmoves PT, PLLC Physical Therapist CurrentSince Sep 18, 2020 Accepting new patients
Dorothea B Southwick Physical Therapist Past Accepting new patients
Physical Therapy Unlimited of Syracuse PC Past Accepting new patients
Welcare Family & Sports Chiropractic, PLLC PastSince Oct 17, 2011 Accepting new patients
Mauro-Bertolo Therapy SVCS PTPC Physical Therapist PastSince Jan 1, 1996 Accepting new patients

Locations

22 Oak St
Ste A
Plattsburgh, NY 12901
Phone (518) 569-1484

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1275521007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BOOTH DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016404",
            "telephone_number": "518-561-2225",
            "fax_number": "518-561-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BOOTH DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016404",
            "telephone_number": "518-561-2225",
            "fax_number": "518-561-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLEY",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "credential": "PT MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0235781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.