NPIMap

Organization Active NPI

Restore Occupational and Physical Therapy Speech Language

  • Contractor
  • Cohoes, NY
National Provider Identifier
1679946586
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
RESTORE OCCUPATIONAL AND PHYSICAL THERAPY SPEECH LANGUAGE
Practice address
81 Mohawk St
Cohoes, NY 12047-2809
Phone
(518) 235-2329
Fax
(518) 235-9791
NPI assigned
Nov 2, 2015
Last updated
Apr 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Jodi A. Hague
Title
Administrator
Phone
(518) 235-2329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171W00000X NY Primary

Addresses

Primary practice location

81 Mohawk St
Cohoes, NY 12047-2809

Mailing address

81 Mohawk St
PO Box 367
Cohoes, NY 12047-2809
Phone (518) 235-2329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190903003123 NY Part B Supplier - Clinic/Group Practice 5991003428 Receives reassigned benefits from 22 practitioners
Practice locations: Cohoes, NY

National Provider Directory

National Provider Directory

Locations

81 Mohawk St
Cohoes, NY 12047
Phone (518) 220-9933

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1679946586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MOHAWK ST",
            "address_2": "PO BOX 367",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472809",
            "telephone_number": "518-235-2329",
            "fax_number": "518-235-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MOHAWK ST",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472809",
            "telephone_number": "518-235-2329",
            "fax_number": "518-235-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE OCCUPATIONAL AND PHYSICAL THERAPY SPEECH LANGUAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "HAGUE",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "518-235-2329"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohoes, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.