Individual provider Active NPI

Kelly A. Coccetti, PT

  • Physical Therapist
  • Clifton Park, NY
National Provider Identifier
1295929925
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013156 Issued in NY
Practice address
648 Plank Rd
Suite 101
Clifton Park, NY 12065-2019
Phone
(518) 268-4800
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 013156 NY Primary

Addresses

Primary practice location

648 Plank Rd
Suite 101
Clifton Park, NY 12065-2019

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

147 Hoosick Street
Massry Center
Troy, NY 12180-2393
Phone (518) 268-5749

Other practice location 2

2 Empire Dr Ste 202
Rensselaer, NY 12144-5730
Phone (518) 286-4990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060112000274 NY Practitioner - Physical Therapist in Private Practice 1557384880 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Physical Therapist CurrentSince Jan 1, 2019 Accepting new patients
Michael D. Wood, PT, PC Physical Therapist Past Accepting new patients
Samaritan Hospital of Troy, New York PastSince Jan 1, 2019 Accepting new patients

Locations

648 Plank Rd
Ste 101
Clifton Park, NY 12065
Phone (518) 268-4800

2 Empire Dr
Ste 202
Rensselaer, NY 12144
Phone (518) 286-4990

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

147 Hoosick St
Ste 202
Troy, NY 12180
Phone (518) 268-5380

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Organizations & group practices 3

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": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1295929925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 PLANK RD",
            "address_2": "SUITE 101",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652019",
            "telephone_number": "518-268-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Hoosick Street",
            "address_2": "Massry Center",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802393",
            "country_code": "US",
            "telephone_number": "518-268-5749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Empire Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121445730",
            "country_code": "US",
            "telephone_number": "518-286-4990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCCETTI",
        "first_name": "KELLY",
        "middle_name": "A.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "013156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.