Individual provider Active NPI

Kayla Malmgren, PTA

  • Physical Therapy Assistant
  • Glens Falls, NY
National Provider Identifier
1841848629
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
009483-1 Issued in NY
Practice address
9 Broad St
Glens Falls, NY 12801-4301
Phone
(518) 409-4288
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 009483-1 NY Primary

Addresses

Primary practice location

9 Broad St
Glens Falls, NY 12801-4301

Mailing address

34 Haskell Ave
Glens Falls, NY 12801-3811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
009483-1NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jason a Campopiano PT PLLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

9 Broad St
Glens Falls, NY 12801
Phone (518) 409-4288

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1841848629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 HASKELL AVE",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BROAD ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014301",
            "telephone_number": "518-409-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMGREN",
        "first_name": "KAYLA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "009483-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.