Individual provider Active NPI

Cara Riesdorph, PT

  • Physical Therapist
  • Hornell, NY
National Provider Identifier
1811224447
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031943 Issued in NY
Practice address
411 Canisteo St
Hornell, NY 14843-2104
Phone
(607) 324-8280
Fax
(607) 324-8283
NPI assigned
Nov 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 031943 NY Primary

Addresses

Primary practice location

411 Canisteo St
Hornell, NY 14843-2104

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Cara Galletta Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210430000064 SC Practitioner - Physical Therapist in Private Practice 1052720232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greenville Proaxis Therapy LLCGroup PAC ID 0244267771, 221 clinicians

Practice addresses (Care Compare)

2646 Boiling Springs Rd
Boiling Springs, SC 29316-6002
Phone (864) 599-0799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy LLC CurrentSince Mar 22, 2021 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Mar 22, 2021 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

2646 Boiling Springs Rd
Boiling Springs, SC 29316
Phone (864) 345-6714

2642 Boiling Springs Rd
Boiling Springs, SC 29316

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

2615 Woodruff Rd
Ste 400
Simpsonville, SC 29681
Phone (864) 537-5016

2125 E Main St
Ste 400
Spartanburg, SC 29307
Phone (864) 285-3615

Organizations & group practices 3

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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1811224447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CANISTEO ST",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148432104",
            "telephone_number": "607-324-8280",
            "fax_number": "607-324-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESDORPH",
        "first_name": "CARA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-03",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARA",
            "last_name": "GALLETTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hornell, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.