Individual provider Active NPI

Kavitha Kumari Russaliah

  • Physical Therapist
  • Albany, NY
National Provider Identifier
1801769930
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
055027 Issued in NY
Practice address
6 Executive Park Dr
Albany, NY 12203-3791
Phone
(518) 512-3452
Fax
(518) 599-0071
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 055027 NY Primary

Addresses

Primary practice location

6 Executive Park Dr
Albany, NY 12203-3791

Mailing address

6 Executive Park Dr
Albany, NY 12203-3791
Phone (518) 512-3452

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
I20260105001006 NY Practitioner - Physical Medicine and Rehabilitation 8123514650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6 Executive Park Dr
Entrance D
Albany, NY 12203-3791

8 Edward St
Cohoes, NY 12047-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055027NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Purificato Physical Therapy PLLC Single Specialty CurrentSince Dec 1, 2025 Accepting new patients

Locations

6 Executive Park Dr
#D
Albany, NY 12203
Phone (518) 512-3452

6 Executive Park Dr
Stuyvesant Plaza, NY 12203
Phone (518) 482-9111

Organizations & group practices 1

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1801769930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033791",
            "telephone_number": "518-512-3452",
            "fax_number": "518-599-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033791",
            "telephone_number": "518-512-3452",
            "fax_number": "518-599-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSALIAH",
        "first_name": "KAVITHA KUMARI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "055027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.