Individual provider Active NPI

Kathleen M Zajac, PT

  • Physical Therapist
  • Rochester, NY
National Provider Identifier
1700913597
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023030-1 Issued in NY
Practice address
720 Latta Rd
#148
Rochester, NY 14612-4100
Phone
(585) 752-1444
Fax
(866) 639-0222
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 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 023030-1 NY Primary

Addresses

Primary practice location

720 Latta Rd
#148
Rochester, NY 14612-4100

Mailing address

PO Box 11471
Albany, NY 12211-0471
Phone (518) 389-1805

Other identifiers 1

IdentifierTypeStateIssuer
023030-1OtherNYLICENSE NUMBER

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
023030-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Jan 3, 2025 Accepting new patients
Weston Paxxon PT, OT & SLP, PLLC Physical Therapist Past Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC PastSince Dec 27, 2020 Accepting new patients

Locations

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

Organizations & group practices 3

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1700913597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11471",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122110471",
            "telephone_number": "518-389-1805",
            "fax_number": "518-389-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 LATTA RD",
            "address_2": "#148",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146124100",
            "telephone_number": "585-752-1444",
            "fax_number": "866-639-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023030-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "023030-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.