Individual provider Active NPI

Catherine A. Dubois, PT

  • Physical Therapist
  • Chatham, NY
National Provider Identifier
1700818333
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007428 Issued in NY
Practice address
43 Shufelt Rd
Chatham, NY 12037-3514
Phone
(518) 755-3171
NPI assigned
Jul 6, 2006
Last updated
Apr 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5296 CT
Physical Therapist 225100000X 007428 NY Primary

Addresses

Primary practice location

43 Shufelt Rd
Chatham, NY 12037-3514

Mailing address

43 Shufelt Rd
Chatham, NY 12037-3514
Phone (518) 755-3171

Other practice location 1

106 Route 66 E
Columbia, CT 06237-1224
Phone (860) 228-0194

Other identifiers 1

IdentifierTypeStateIssuer
00007428MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024002413 CT Practitioner - Physical Therapist in Private Practice 7618220419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5296CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Physical Therapy LLC Physical Therapist CurrentSince Sep 21, 2018 Accepting new patients

Locations

106 Route 66 E
Columbia, CT 06237
Phone (860) 228-0194

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1700818333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SHUFELT RD",
            "city": "CHATHAM",
            "state": "NY",
            "postal_code": "120373514",
            "telephone_number": "518-755-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 SHUFELT RD",
            "city": "CHATHAM",
            "state": "NY",
            "postal_code": "120373514",
            "telephone_number": "518-755-3171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Route 66 E",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "CT",
            "postal_code": "062371224",
            "country_code": "US",
            "telephone_number": "860-228-0194",
            "fax_number": "860-228-2694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "CATHERINE",
        "middle_name": "A.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "5296",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "007428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.