Kelsy Boldt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

046032 Issued in NY

Practice address

110 Assembly Dr
Mendon, NY 14506-9600

Phone

(585) 582-1330

Fax

(585) 582-2537

NPI assigned

Sep 29, 2020

Last updated

Dec 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelsy Cornish Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shuman Physical Therapy Associates PCGroup PAC ID 6709869209, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shuman Physical Therapy Associates, P.C.

  dba Lattimore Physical Therapy

  • Physical Therapist
  • Rochester, NY
  • NPI 1003928755
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1811504368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "MENDON",
            "state": "NY",
            "postal_code": "145060725",
            "telephone_number": "585-582-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ASSEMBLY DR",
            "city": "MENDON",
            "state": "NY",
            "postal_code": "145069600",
            "telephone_number": "585-582-1330",
            "fax_number": "585-582-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDT",
        "first_name": "KELSY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSY",
            "last_name": "CORNISH",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Marie Andolina, M.D.
• Emma Arnold, DPT
• Zachery Barnes
• Rachelle Buchanan
• Lacey Rae Fox-Smith, PNP
• Rebecca D Gargan, M.D.
• Gupta Family Dentistry PLLC (Gupta Family Dentistry of Mendon)
• Keven Hagen, DC

• Physical Therapist in Mendon, NY
• Providers in Mendon, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.