Ian Shultis, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

048547 Issued in NY

Practice address

2 Front St
Millbrook, NY 12545-5948

Phone

(845) 677-5021

NPI assigned

Jan 12, 2015

Last updated

Sep 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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.

• New York Physical and Occupational Therapy Services, PLLC

  dba New York Therapy And Wellness

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1356703631
  Medicare reassignment NPD

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1841689049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FRONT ST",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "125455948",
            "telephone_number": "845-677-5021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "517 Noxon Rd",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126033750",
            "country_code": "US",
            "telephone_number": "845-238-1859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULTIS",
        "first_name": "IAN",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002788",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren J Scelia, LCSW
• Kristina Schrader, PTA
• Laureen Rose Scianimanico, M.S., CCC-SLP
• Shannon Shaw LCSW, PLLC
• Amelia Shillingford, NP
• Warren William Skov, MSW LCSWR
• Victor Y Soltis, DDS
• Dawn Spagna
• St Germain Family Care, Inc.
• Christa Ann St. Germain, DC, MSN, FNP-BC

• Physical Therapist in Millbrook, NY
• Providers in Millbrook, 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 Sep 17, 2024; 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.