Individual provider Active NPI

Kalliopi K Nestor, MD

  • Physical Medicine & Rehabilitation Physician
  • Coudersport, PA
National Provider Identifier
1720194608
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD429725 Issued in PA
Practice address
1001 E 2ND St
Coudersport, PA 16915-8161
Phone
(814) 274-9300
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD429725 PA Primary

Addresses

Primary practice location

1001 E 2ND St
Coudersport, PA 16915-8161

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161

Other identifiers 2

IdentifierTypeStateIssuer
1906113OtherPABLUE SHIELD
MD429725OtherPALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223000395 NY Practitioner - Physical Medicine and Rehabilitation 8820094212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

6119 US Hwy 11
Canton, NY 13617-3991
Phone (315) 265-3300

Hospital & facility affiliations

  • Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197
  • Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324
  • Gouverneur Hospital Hospital, Gouverneur, NY, CCN 331315
  • SLHS Massena, Inc Hospital, Massena, NY, CCN 331322

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD429725PAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine & Rehabilitation of Long Island Physical Medicine & Rehabilitation CurrentSince Dec 1, 2018 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jan 3, 2022 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jan 3, 2022 Accepting new patients
Charles Cole Memorial Hospital D/B/a Upmc Cole Past Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

234 Orinoco Dr
Brightwaters, NY 11718
Phone (631) 300-0079

6119 US Highway 11
Ste 11
Canton, NY 13617

6119 US Highway 11
Canton, NY 13617
Phone (315) 261-5810

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1720194608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTOR",
        "first_name": "KALLIOPI",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD429725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1906113",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MD429725",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coudersport, PA

Sources for this page

Verify at the official NPI Registry.