Individual provider Active NPI

Stefanie Marie Palillo, MPT

  • Physical Therapist
  • Scranton, PA
National Provider Identifier
1780807933
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020440 Issued in PA
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

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2510492OtherPABC/BS
102584725MedicaidPA

Other names 1

  • Stefanie Marie Yule Former name

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
40QA01241100NJMDPhysical Therapist
PT020440PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist PastSince Jun 1, 2017 Accepting new patients
Physical Therapy Associates of Northeast Pennsylvania Inc Physical Therapist PastSince Sep 27, 2002 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.

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.

Verify at the official NPI Registry.