Active NPI
Jill Tyksinski, PT
- Physical Therapist
- Clinton, NY
National Provider Identifier
1447525464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 016551-1
- Practice address
- 3455 Craig Rd
Clinton, NY 13323-3911 - Phone
- (315) 525-7714
- NPI assigned
- Mar 9, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 016551-1 | NY | Primary |
Addresses
Primary practice location
3455 Craig Rd
Clinton, NY 13323-3911
Mailing address
3455 Craig Rd
Clinton, NY 13323-3911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040401000992 | NY | Practitioner - Physical Therapist in Private Practice | 8921090606 | Practice locations: Clinton, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016551-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1447525464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3455 CRAIG RD",
"city": "CLINTON",
"state": "NY",
"postal_code": "133233911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 CRAIG RD",
"city": "CLINTON",
"state": "NY",
"postal_code": "133233911",
"telephone_number": "315-525-7714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYKSINSKI",
"first_name": "JILL",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-09",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "016551-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.