NPIMap

Organization Active NPI

Spa Physical Therapy, PC

  • Physical Therapist
  • Saratoga Springs, NY
National Provider Identifier
1487765095
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPA PHYSICAL THERAPY, PC
Practice address
7 Wells St
Suite 101
Saratoga Springs, NY 12866-1200
Phone
(518) 587-0637
Fax
(518) 587-2515
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Colleen Backus, P.T.NPI 1891758694
Title
Owner
Phone
(518) 587-0637

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

7 Wells St
Suite 101
Saratoga Springs, NY 12866-1200

Mailing address

7 Wells St
Suite 101
Saratoga Springs, NY 12866-1200
Phone (518) 587-0637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000951 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6103808142 Receives reassigned benefits from 2 practitioners
Practice locations: Saratoga Springs, NY

National Provider Directory

National Provider Directory

Locations

19 West Ave
Ste 104
Saratoga Springs, NY 12866
Phone (518) 587-0637

7 Wells St
Ste 101
Saratoga Springs, NY 12866
Phone (518) 587-0637

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487765095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WELLS ST",
            "address_2": "SUITE 101",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661200",
            "telephone_number": "518-587-0637",
            "fax_number": "518-587-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WELLS ST",
            "address_2": "SUITE 101",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661200",
            "telephone_number": "518-587-0637",
            "fax_number": "518-587-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACKUS",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-587-0637",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 22, 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.