Active NPI
Stefanie Marie Palillo, MPT
- Physical Therapist
- Scranton, PA
National Provider Identifier
1780807933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT020440
- Practice address
- 423 Scranton Carbondale Hwy
Scranton, PA 18508-1115 - Phone
- (570) 207-5502
- Fax
- (570) 207-5511
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01241100 | NJ | |
| Physical Therapist | 225100000X | 030914 | NY | |
| Physical Therapist | 225100000X | PT020440 | PA | Primary |
Addresses
Primary practice location
423 Scranton Carbondale Hwy
Scranton, PA 18508-1115
Mailing address
423 Scranton Carbondale Hwy
Scranton, PA 18508-1115
Phone (570) 207-5502
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2510492 | Other | PA | BC/BS |
| 102584725 | Medicaid | PA |
Other names 1
- Stefanie Marie Yule
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01241100 | NJ | MD | Physical Therapist |
| PT020440 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pivot Physical Therapy of Pennsylvania, LLC | Physical Therapist | Past | Accepting new patients |
| Physical Therapy Associates of Northeast Pennsylvania Inc | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Old Forge, PA
- NPI 1326054750
Physical Therapist
-
- Physical Therapist
- South Abington Township, PA
- NPI 1881132488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1780807933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 SCRANTON CARBONDALE HWY",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185081115",
"telephone_number": "570-207-5502",
"fax_number": "570-207-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "423 SCRANTON CARBONDALE HWY",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185081115",
"telephone_number": "570-207-5502",
"fax_number": "570-207-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALILLO",
"first_name": "STEFANIE",
"middle_name": "MARIE",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01241100",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "030914",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT020440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "2510492",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102584725",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STEFANIE",
"last_name": "YULE",
"middle_name": "MARIE",
"credential": "MPT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.