Individual provider Active NPI

Kayla Radzyminski

  • Physical Therapist
  • Latham, NY
National Provider Identifier
1619857307
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054969 Issued in NY
Practice address
711 Troy Schenectady Rd Ste 216
Latham, NY 12110-2461
Phone
(518) 786-1665
Fax
(518) 785-0056
NPI assigned
Sep 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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 054969 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd Ste 216
Latham, NY 12110-2461

Mailing address

711 Troy Schenectady Rd Ste 209
Latham, NY 12110-2461
Phone (518) 786-1667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250917000444 NY Practitioner - Physical Therapist in Private Practice 4789188418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

711 Troy Schenectady Rd
Suite 209
Latham, NY 12110-2461

711 Troy Schenectady Rd
Suite 209
Latham, NY 12110-2477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054969NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Nicolla Consulting Services, PLLC Physical Therapist CurrentSince Aug 13, 2025 Accepting new patients
Nicolla and Associates, PT & OT Services, PLLC Physical Therapist CurrentSince Aug 13, 2025 Accepting new patients
Thomas Nicolla Consulting Services, PLLC PastSince Sep 8, 2025 Accepting new patients

Locations

711 Troy Schenectady Rd
Ste 209
Latham, NY 12110
Phone (518) 786-1667

711 Troy Schenectady Rd
Ste 216
Latham, NY 12110
Phone (518) 786-1665

Organizations & group practices 3

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": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1619857307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "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 STE 216",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-786-1665",
            "fax_number": "518-785-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZYMINSKI",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054969",
            "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 Sep 4, 2025; 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.