Jill A Spinoso, PT
Individual provider Active NPI Physical Therapist · De Witt, NY
NPI 1326339599 · NPPES record last updated Apr 22, 2011
Key facts
- NPI
- 1326339599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 010788 (NY)
- Practice address
- 5719 Widewaters Pkwy
De Witt, NY 13214-1985 - Phone
- (315) 449-1301
- Fax
- (315) 449-2707
- NPI assigned
- Apr 22, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- State University of New York at Buffalo School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mary Lou Corcoran PT PC
Practice addresses (Care Compare)
6711 Towpath Rd
East Syracuse, NY 13057-9510
Phone (315) 637-4747
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110711000363 | NY | Practitioner - Physical Therapist in Private Practice | 7214115583 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010788 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Lou Corcoran PT, P.C. | Current |
Accepting new patients |
Locations
6711 Towpath Rd
Ste 100
East Syracuse, NY 13057
Phone (315) 637-4747
6711 Towpath Rd
East Syracuse, NY 13057
Phone (315) 637-4747
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 010788 | NY | Yes |
Addresses
Primary practice location
5719 Widewaters Pkwy
De Witt, NY 13214-1985
Mailing address
231 Walton St
Suite 200
Syracuse, NY 13202-1885
Phone (315) 478-0380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02052091 | Other | NY | MEDCAID GROUP |
| AA0171 | Other | NY | MEDICARE GROUP |
| AA0172 | Other | NY | MEDICARE GROUP ID |
Other providers in De Witt, NY
- Shoppingtown Dental Services PC
- Walter H Short
- Erin Katherine Skelly
- Sandra Sleight
- Eileen Marie Spillane-Healy
- David Stubbs
- David Badi Thurber
- Christy Lynn Tubbs
- Amy Vasquez
- I. Michael Vella
All providers in De Witt, 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 Apr 22, 2011. 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.