Amanda Notley-Kim, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

039663 Issued in NY

Practice address

15 Lake Ridge PLZ
Valley Cottage, NY 10989-1925

Phone

(845) 675-8444

Fax

(845) 675-0333

NPI assigned

Feb 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amanda Notley Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportscare Physical Therapy of Ny, P.C.Group PAC ID 8123102092, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sportscare Physical Therapy of Ny, P.C.

  • Physical Therapist
  • West Nyack, NY
  • NPI 1003098138

  NY, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Empire Orthopedic Physical Therapy and Rehabilitation, PLLC

  • Physical Therapy Clinic/Center
  • Valley Cottage, NY
  • NPI 1538671870

  NY, Physical Therapist

  Medicare reassignment NPD
• Proclinix Sports Physical Therapy Chiropractic Wellness,PLLC

  • Physical Therapist
  • Armonk, NY
  • NPI 1114132511

  NY, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1588022982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109890493",
            "telephone_number": "845-675-8444",
            "fax_number": "845-675-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LAKE RIDGE PLZ",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109891925",
            "telephone_number": "845-675-8444",
            "fax_number": "845-675-0333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Tompkins Ave",
            "address_purpose": "LOCATION",
            "city": "Pleasantville",
            "state": "NY",
            "postal_code": "105703144",
            "country_code": "US",
            "telephone_number": "914-202-0700",
            "fax_number": "914-462-3444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOTLEY-KIM",
        "first_name": "AMANDA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "NOTLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Valley Cottage, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.