Active NPI
Kathy J. Polkowski, P.T.
- Physical Therapist
- Auburn, NY
National Provider Identifier
1336202019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 024426-1
- Practice address
- 180 North St
Auburn, NY 13021-1811 - Phone
- (315) 255-3623
- Fax
- (315) 255-0852
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 024426-1 | NY | Primary |
Addresses
Primary practice location
180 North St
Auburn, NY 13021-1811
Mailing address
4932 NE Townline Rd
Marcellus, NY 13108-9792
Phone (315) 488-3150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1083 Waterloo Geneva Rd
Waterloo, NY 13165-1202
Phone (315) 856-8257
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024426 | NY | MD | Clinical Child & Adolescent Psychologist |
| 024426-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Cayuga Counties Chapter Nysarc, Inc. | Current | Accepting new patients | |
| Seneca Cayuga Counties Chapter Nysarc, Inc. | Current | Accepting new patients |
Locations
180 North St
Auburn, NY 13021
Phone (315) 255-2285
1521 Clark Street Rd
Auburn, NY 13021
Phone (315) 253-7331
1083 Waterloo Geneva Rd
Waterloo, NY 13165
Phone (315) 539-4049
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.
-
- Voluntary or Charitable Agency
- Waterloo, NY
- NPI 1497804215
-
- Voluntary or Charitable Agency
- Auburn, NY
- NPI 1104970557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405641600000",
"number": "1336202019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4932 NE TOWNLINE RD",
"city": "MARCELLUS",
"state": "NY",
"postal_code": "131089792",
"telephone_number": "315-488-3150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 NORTH ST",
"city": "AUBURN",
"state": "NY",
"postal_code": "130211811",
"telephone_number": "315-255-3623",
"fax_number": "315-255-0852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLKOWSKI",
"first_name": "KATHY",
"middle_name": "J.",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2014-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "024426-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Auburn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.