Individual provider Active NPI

Kim Teter, PT

  • Physical Therapist
  • Latham, NY
National Provider Identifier
1316922453
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008009-1 Issued in NY
Practice address
711 Troy Schenectady Rd
Suite 214
Latham, NY 12110-2442
Phone
(518) 690-2282
Fax
(518) 690-2884
NPI assigned
Dec 13, 2005
Last updated
Feb 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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 008009-1 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd
Suite 214
Latham, NY 12110-2442

Mailing address

711 Troy Schenectady Rd
Suite 209
Latham, NY 12110-2442
Phone (518) 786-1667

Other identifiers 3

IdentifierTypeStateIssuer
01700590MedicaidNY
CC0236OtherNYMEDICARE
650021313OtherNYRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111005000246 NY Practitioner - Physical Therapist in Private Practice 3375715865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

989 Route 146
Suite 100
Clifton Park, NY 12065-3647
Phone (518) 371-5221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008009-1NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolla and Associates, PT & OT Services, PLLC Physical Therapist CurrentSince May 1, 2000 Accepting new patients
Thomas Nicolla Consulting Services, PLLC Physical Therapist CurrentSince May 1, 2000 Accepting new patients

Locations

989 Route 146
Ste 100
Clifton Park, NY 12065
Phone (518) 264-4800

711 Troy Schenectady Rd
Ste 209
Latham, NY 12110
Phone (518) 786-1667

711 Troy Schenectady Rd
Ste 214
Latham, NY 12110
Phone (518) 690-2882

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, 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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1316922453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-786-1667",
            "fax_number": "518-786-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 214",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-690-2282",
            "fax_number": "518-690-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETER",
        "first_name": "KIM",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "008009-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01700590",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CC0236",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650021313",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.