Individual provider Active NPI

Krista Dendor Bryant

  • Pediatric Occupational Therapist
  • East Greenbush, NY
National Provider Identifier
1831685338
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
022658 Issued in NY
Practice address
673 Columbia Tpke
East Greenbush, NY 12061-2130
Phone
(518) 233-0544
NPI assigned
Jul 8, 2018
Last updated
Sep 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X 022658 NY Primary

Addresses

Primary practice location

673 Columbia Tpke
East Greenbush, NY 12061-2130

Mailing address

35 Perry Ave
Latham, NY 12110-2433
Phone (518) 867-9731

Other practice location 1

711 Troy Schenectady Rd
Latham, NY 12110-2442
Phone (518) 786-1665

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200304000354 NY Practitioner - Occupational Therapist in Private Practice 7719314772 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022658NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolla and Associates, PT & OT Services, PLLC Single Specialty CurrentSince Feb 13, 2020 Accepting new patients
Thomas Nicolla Consulting Services, PLLC Single Specialty CurrentSince Feb 13, 2020 Accepting new patients
Capital District Beginnings Past Accepting new patients

Locations

711 Troy Schenectady Rd
Ste 209
Latham, NY 12110
Phone (518) 786-1667

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1831685338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PERRY AVE",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102433",
            "telephone_number": "518-867-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 COLUMBIA TPKE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120612130",
            "telephone_number": "518-233-0544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Troy Schenectady Rd",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121102442",
            "country_code": "US",
            "telephone_number": "518-786-1665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "KRISTA",
        "middle_name": "DENDOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-08",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "022658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenbush, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.