Alexander Pisanello, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04665901 Issued in NY

Practice address

85 Snowberry Rd
Ballston Spa, NY 12020-4463

Phone

(518) 690-5942

NPI assigned

Dec 17, 2020

Last updated

Feb 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Green Room Physical Therapy PLLCGroup PAC ID 2668887100, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Green Room Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Troy, NY
  • NPI 1083154132

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Alexander Pisanello Physical Therapy PLLC

  • Physical Therapist
  • Malta, NY
  • NPI 1669307658
  NPD Authorized official

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1750977211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SNOWBERRY RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120204463",
            "telephone_number": "518-690-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SNOWBERRY RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120204463",
            "telephone_number": "518-690-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANELLO",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "04665901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Pezzulo, RN
• Pharmacy Associates of Glens Falls, LLC (Omnicare of Ballston Spa)
• Kristine A Phelps, M.S. SPED
• Physical Therapy Associates of Schenectady, PC
• Todd Michael Pikor, R.PH
• Shirley Podkulski, RN
• Anthony D Pomato, D.D.S.
• Kristen Pommenville, MSN. RN
• Michelle Marie Powers
• Thomas John Pray, DDS

• Physical Therapist in Ballston Spa, NY
• Providers in Ballston Spa, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.