Individual provider Active NPI

Jesse A Byers, DPT

  • Physical Therapist
  • Latham, NY
National Provider Identifier
1508339474
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040958 Issued in NY
Practice address
1182 Troy Schenectady Rd Ste LL02
Latham, NY 12110-1000
Phone
(518) 289-5242
NPI assigned
Jan 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 040958 NY Primary

Addresses

Primary practice location

1182 Troy Schenectady Rd Ste LL02
Latham, NY 12110-1000

Mailing address

108 Shaker Run
Colonie, NY 12205-2452
Phone (541) 740-0005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210930002423 NY Practitioner - Physical Therapist in Private Practice 6406253673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Physical Therapy Wellness, PLLCGroup PAC ID 7315482882, 5 clinicians

Practice addresses (Care Compare)

1 Barney Rd
Suite 120
Clifton Park, NY 12065-5823
Phone (518) 373-0735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040958NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Physical Therapy Wellness, PLLC Physical Therapist CurrentSince Jan 7, 2025 Accepting new patients
Cocozzo Physical Therapy, PC Physical Therapist Past Accepting new patients

Locations

1 Barney Rd
Ste 120
Clifton Park, NY 12065
Phone (518) 373-0735

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.

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1508339474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SHAKER RUN",
            "city": "COLONIE",
            "state": "NY",
            "postal_code": "122052452",
            "telephone_number": "541-740-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 TROY SCHENECTADY RD STE LL02",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101000",
            "telephone_number": "518-289-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYERS",
        "first_name": "JESSE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040958",
            "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 Mar 11, 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.