Individual provider Active NPI

Nicole Lynn Krawczeski, PT

  • Physical Therapist
  • Gloversville, NY
National Provider Identifier
1285817023
Registry record updated Dec 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021640-1 Issued in NY
Practice address
1165 County Highway 122
Gloversville, NY 12078-6131
Phone
(518) 725-1937
NPI assigned
Dec 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2007

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 021640-1 NY Primary

Addresses

Primary practice location

1165 County Highway 122
Gloversville, NY 12078-6131

Mailing address

1165 County Highway 122
Gloversville, NY 12078-6131
Phone (518) 725-1937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214000057 NY Practitioner - Physical Therapist in Private Practice 0042578320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc Inc Fulton County Chapter 27 clinicians

Practice addresses (Care Compare)

127 E State St
Gloversville, NY 12078-1204
Phone (518) 736-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021640NYMDClinical Psychologist
021640-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc Fulton County Chapter CurrentSince Jan 21, 2024 Accepting new patients
Genesis Medical Health PC Past Accepting new patients

Locations

127 E State St
Gloversville, NY 12078
Phone (518) 773-7931

465 N Perry St
Johnstown, NY 12095
Phone (518) 736-3937

Organizations & group practices 2

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": "1197763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197763200000",
    "number": "1285817023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 COUNTY HIGHWAY 122",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120786131",
            "telephone_number": "518-725-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 COUNTY HIGHWAY 122",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120786131",
            "telephone_number": "518-725-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAWCZESKI",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-16",
        "last_updated": "2007-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021640-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2007; 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.