Denise Serotta Jackson, P.T.
Individual provider Active NPI Physical Therapist · Glen Falls, NY
NPI 1295732071 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1295732071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 012831-1 (NY)
- Practice address
- Stephen W. Bassin, P.T., P.C.
32 Sherman Ave
Glen Falls, NY 12801 - Phone
- (518) 793-7136
- Fax
- (518) 793-7142
- NPI assigned
- Jul 7, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nova Rehab PT OT PLLC
Practice addresses (Care Compare)
4 W Main St
Cambridge, NY 12816-1131
Phone (347) 631-6150
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110330000593 | NY | Practitioner - Physical Therapist in Private Practice | 5496938342 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012831-1 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 012831-1 | NY | Yes |
Addresses
Primary practice location
Stephen W. Bassin, P.T., P.C.
32 Sherman Ave
Glen Falls, NY 12801
Mailing address
Stephen W. Bassin, P.T., P.C.
32 Sherman Ave
Glen Falls, NY 12801
Phone (518) 793-7136
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000499025001 | Other | NY | BLUESHIELD OF NE NY |
| 01699036 | Medicaid | NY | |
| DJ0QL58710 | Other | NY | EMPIRE BC/BS |
Other providers in Glen Falls, NY
- Stephen Wayne Bassin
- Dean Clickner
- Leslie Collura
- Bridget Giernacky
- Crystal Elizabeth Hoban
- Macnaughton Chiropractic, PLLC
All providers in Glen Falls, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.