Active NPI
Olivia Derleth
- Physical Therapist
- Hopewell Junction, NY
National Provider Identifier
1689130395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0404361
- Practice address
- 2531 Route 52 Ste 2
Hopewell Junction, NY 12533-3227 - Phone
- (845) 592-4747
- Fax
- (845) 592-4749
- NPI assigned
- Feb 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0404361 | NY | Primary |
Addresses
Primary practice location
2531 Route 52 Ste 2
Hopewell Junction, NY 12533-3227
Mailing address
16 Maybrook Rd Ste K
Campbell Hall, NY 10916-2741
Phone (845) 636-4344
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0404361 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612310400000",
"number": "1689130395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 MAYBROOK RD STE K",
"city": "CAMPBELL HALL",
"state": "NY",
"postal_code": "109162741",
"telephone_number": "845-636-4344",
"fax_number": "845-636-4355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2531 ROUTE 52 STE 2",
"city": "HOPEWELL JUNCTION",
"state": "NY",
"postal_code": "125333227",
"telephone_number": "845-592-4747",
"fax_number": "845-592-4749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERLETH",
"first_name": "OLIVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-18",
"last_updated": "2021-02-03",
"certification_date": "2021-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "0404361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hopewell Junction, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.