Individual provider Active NPI

Jennifer Runkel, PT

  • Physical Therapist
  • Saratoga Springs, NY
National Provider Identifier
1427017672
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027542-1 Issued in NY
Practice address
131 Lawrence St
Saratoga Springs, NY 12866-1399
Phone
(518) 691-1454
Fax
(518) 691-1460
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 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 027542-1 NY Primary

Addresses

Primary practice location

131 Lawrence St
Saratoga Springs, NY 12866-1399

Mailing address

131 Lawrence St
Saratoga Springs, NY 12866-1399
Phone (518) 691-1454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051028000897 NY Practitioner - Physical Therapist in Private Practice 5092732016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027542-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Nicolla Consulting Services, PLLC Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1427017672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 LAWRENCE ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661399",
            "telephone_number": "518-691-1454",
            "fax_number": "518-691-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LAWRENCE ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661399",
            "telephone_number": "518-691-1454",
            "fax_number": "518-691-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNKEL",
        "first_name": "JENNIFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027542-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.