Individual provider Active NPI

Shelley E Olsted, PT

  • Physical Therapist
  • Clifton Park, NY
National Provider Identifier
1700831948
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0267681 Issued in NY
Practice address
4 Emma Lane
Suite 401
Clifton Park, NY 12065
Phone
(518) 383-2610
Fax
(518) 383-8188
NPI assigned
May 24, 2006
Last updated
Jan 31, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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 0267681 NY Primary

Addresses

Primary practice location

4 Emma Lane
Suite 401
Clifton Park, NY 12065

Mailing address

4 Emma Lane
Suite 401
Clifton Park, NY 12065
Phone (518) 383-2610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051117000547 NY Practitioner - Physical Therapist in Private Practice 0345269411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clifton Park Physical Therapy PLLCGroup PAC ID 2769669266, 4 clinicians

Practice addresses (Care Compare)

4 Emma LN
Suite 401
Clifton Park, NY 12065-3705
Phone (518) 383-2610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0267681NYMDPhysical Therapist
026768NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Park Physical Therapy PLLC Physical Therapist CurrentSince Jul 7, 2011 Accepting new patients
Michael D. Wood, PT, PC Physical Therapist Past Accepting new patients

Locations

4 Emma Ln
Ste 1
Clifton Park, NY 12065
Phone (518) 383-2610

4 Emma Ln
Ste 401
Clifton Park, NY 12065
Phone (518) 383-2610

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1700831948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EMMA LANE",
            "address_2": "SUITE 401",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-383-2610",
            "fax_number": "518-383-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EMMA LANE",
            "address_2": "SUITE 401",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-383-2610",
            "fax_number": "518-383-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSTED",
        "first_name": "SHELLEY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0267681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.