Individual provider Active NPI

Svetlana Kotlin, PT

  • Physical Therapist
  • Malta, NY
National Provider Identifier
1538273982
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0180481 Issued in NY
Practice address
288 Thimbleberry Rd
Malta, NY 12020-4388
Phone
(518) 783-0286
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0180481 NY Primary

Addresses

Primary practice location

288 Thimbleberry Rd
Malta, NY 12020-4388

Mailing address

288 Thimbleberry Rd
Malta, NY 12020-4388
Phone (518) 783-0286

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0180481NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1538273982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 THIMBLEBERRY RD",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204388",
            "telephone_number": "518-783-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 THIMBLEBERRY RD",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204388",
            "telephone_number": "518-783-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLIN",
        "first_name": "SVETLANA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0180481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.