Individual provider Active NPI

Nicole Decrescenzo, PT, MSPT

  • Physical Therapist
  • Mechanicville, NY
National Provider Identifier
1649308404
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026986 Issued in NY
Practice address
218 S. Central Avenue
Mechanicville, NY 12118
Phone
(518) 664-1188
Fax
(518) 664-1187
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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 026986 NY Primary

Addresses

Primary practice location

218 S. Central Avenue
Mechanicville, NY 12118

Mailing address

218 S. Central Avenue
Mechanicville, NY 12118
Phone (518) 664-1188

Other practice location 1

648 Plank Rd Ste 101
Clifton Park, NY 12065-2062
Phone (518) 268-4800

Other practice location 2

147 Hoosick St
Troy, NY 12180-2393
Phone (518) 268-5749

Other practice location 3

2 Empire Dr Ste 202
Rensselaer, NY 12144-5730
Phone (518) 286-4990

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
026986NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coxsackie Physical Therapy Associates, PC Physical Therapist PastSince Dec 1, 2003 Accepting new patients
Capital Area Physical Therapy, PLLC PastSince Aug 26, 2013 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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1649308404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 S. CENTRAL AVENUE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "12118",
            "telephone_number": "518-664-1188",
            "fax_number": "518-664-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S. CENTRAL AVENUE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "12118",
            "telephone_number": "518-664-1188",
            "fax_number": "518-664-1187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "648 Plank Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120652062",
            "country_code": "US",
            "telephone_number": "518-268-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 Hoosick St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802393",
            "country_code": "US",
            "telephone_number": "518-268-5749",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Empire Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Rensselaer",
            "state": "NY",
            "postal_code": "121445730",
            "country_code": "US",
            "telephone_number": "518-286-4990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECRESCENZO",
        "first_name": "NICOLE",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.