Active NPI
Stacey Demeo, PT
- Physical Therapist
- Latham, NY
National Provider Identifier
1497907844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012496-1
- Practice address
- 711 Troy Schenectady Rd
Suite 216
Latham, NY 12110-2442 - Phone
- (518) 786-1665
- Fax
- (518) 785-0056
- NPI assigned
- Oct 16, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 012496-1 | NY | Primary |
Addresses
Primary practice location
711 Troy Schenectady Rd
Suite 216
Latham, NY 12110-2442
Mailing address
711 Troy Schenectady Rd
Suite 209
Latham, NY 12110-2442
Phone (518) 786-1667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012496-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Nicolla Consulting Services, PLLC | Past | Accepting new patients | |
| Nicolla and Associates, PT & OT Services, PLLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Latham, NY
- NPI 1487633152
Physical Therapist
-
- Specialist
- Latham, NY
- NPI 1992850564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224115200000",
"number": "1497907844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD",
"address_2": "SUITE 209",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102442",
"telephone_number": "518-786-1667",
"fax_number": "518-786-1954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD",
"address_2": "SUITE 216",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102442",
"telephone_number": "518-786-1665",
"fax_number": "518-785-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMEO",
"first_name": "STACEY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-16",
"last_updated": "2008-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "012496-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.