Mallory Jo Miles

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

043929 Issued in NY

Practice address

178 Grandview Dr
Cobleskill, NY 12043-5144

Phone

(518) 254-3261

Fax

(518) 254-3335

NPI assigned

Jan 15, 2020

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Balanced Health Physical TherapyGroup PAC ID 1456672591, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Balanced Health Physical Therapy

  • Physical Therapy Clinic/Center
  • Gloversville, NY
  • NPI 1144625401

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1427698752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 GRANDVIEW DR",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120435144",
            "telephone_number": "518-254-3261",
            "fax_number": "518-254-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 GRANDVIEW DR",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120435144",
            "telephone_number": "518-254-3261",
            "fax_number": "518-254-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "MALLORY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Martin, PT, DPT
• Desmond Eric Martz, PHARM D
• Mary Imogene Bassett Hospital (Bassett Healthcare - Cobleskill)
• James Michael McMahon, DC
• Joy L Meyer, MD
• Kristi Miner, RN
• Cynthia Mitteager, M.S.ED., CCC-SLP
• Montefiore Medical Center
• Dennis Robert Moren, D.M.D.
• Robert Martin Nelson, D.M.D.

• Physical Therapist in Cobleskill, NY
• Providers in Cobleskill, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.