Individual provider Active NPI

Maureen Marie Clancy, PT DPT

  • Physical Therapist
  • Clifton Park, NY
National Provider Identifier
1790734416
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0229771 Issued in NY
Practice address
4 Emma Lane
Suite 401
Clifton Park, NY 12065
Phone
(518) 383-2610
Fax
(518) 383-8188
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 0229771 NY Primary

Addresses

Primary practice location

4 Emma Lane
Suite 401
Clifton Park, NY 12065

Mailing address

4 Emma Lane
Suite 401
Clifton Park, NY 12065
Phone (518) 383-2610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810002797 MA Practitioner - Physical Therapist in Private Practice 3476936337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Health 360 LLCGroup PAC ID 8325441603, 14 clinicians

Practice addresses (Care Compare)

289 Great Rd
Suite 306
Acton, MA 01720-4766
Phone (508) 667-0114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0229771NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Health 360 LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Michael D. Wood, PT, PC Physical Therapist Past Accepting new patients

Locations

289 Great Rd
Ste 306
Acton, MA 01720
Phone (508) 667-0114

289 Great Rd
Ste 102
Acton, MA 01720
Phone (978) 263-3600

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790734416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EMMA LANE",
            "address_2": "SUITE 401",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-383-2610",
            "fax_number": "518-383-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EMMA LANE",
            "address_2": "SUITE 401",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-383-2610",
            "fax_number": "518-383-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "MAUREEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0229771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.