NPIMap

Organization Active NPI

East Coast Audiology and Physical Therapy, PLLC

  • Physical Therapist
  • Watertown, NY
National Provider Identifier
1376048652
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021628-1 Issued in NY
Legal business name
EAST COAST AUDIOLOGY AND PHYSICAL THERAPY, PLLC
Practice address
53-59 Public SQ Ste 202
Watertown, NY 13601-2674
Phone
(315) 786-3225
Fax
(315) 786-3215
NPI assigned
Mar 28, 2018
Last updated
Nov 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sarah R Sugden, AU.D.NPI 1306065289
Title
President / Audiologist
Phone
(315) 786-3225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 021628-1 NY Primary
Audiologist 231H00000X 001576 NY

Addresses

Primary practice location

53-59 Public SQ Ste 202
Watertown, NY 13601-2674

Mailing address

53-59 Public SQ Ste 202
Watertown, NY 13601-2674
Phone (315) 786-3225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211210001915 NY Part B Supplier - Clinic/Group Practice 8820488547 Receives reassigned benefits from 15 practitioners
Practice locations: Evans Mills, NY; Fayetteville, NY; Watertown, NY
O20211223001554 AZ Part B Supplier - Clinic/Group Practice 8820488547 Receives reassigned benefits from 4 practitioners
Practice locations: Surprise, AZ

National Provider Directory

National Provider Directory

Locations

14239 W Bell Rd
Ste 104
Surprise, AZ 85374
Phone (315) 786-3225

26000 US Route 11
Evans Mills, NY 13637
Phone (315) 786-3225

544 Towne Dr
Fayetteville, NY 13066
Phone (315) 637-8800

53-59 Public Sq
Ste 202
Watertown, NY 13601
Phone (315) 786-3225

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1376048652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQ STE 202",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-786-3225",
            "fax_number": "315-786-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53-59 PUBLIC SQ STE 202",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012674",
            "telephone_number": "315-786-3225",
            "fax_number": "315-786-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST AUDIOLOGY AND PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-28",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "SUGDEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT / AUDIOLOGIST",
        "authorized_official_telephone_number": "315-786-3225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021628-1",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.