Individual provider Active NPI

Marcin Standa

  • Geriatric Physical Therapist
  • Clifton Park, NY
National Provider Identifier
1851668156
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
021042-1 Issued in NY
Practice address
7 Oakleaf Dr
Clifton Park, NY 12065
Phone
(518) 588-9022
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 021042-1 NY Primary

Addresses

Primary practice location

7 Oakleaf Dr
Clifton Park, NY 12065

Mailing address

7 Oakleaf Dr
Clifton Park, NY 12065-6234
Phone (518) 588-9092

Other names 1

  • Marcin Standa Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130216000027 NY Practitioner - Physical Therapist in Private Practice 5799939930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021042-1NYMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Occupational and Physical Therapy Speech Language CurrentSince Apr 1, 2016 Accepting new patients

Locations

81 Mohawk St
Cohoes, NY 12047
Phone (518) 220-9933

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, 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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1851668156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 OAKLEAF DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656234",
            "telephone_number": "518-588-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 OAKLEAF DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-588-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDA",
        "first_name": "MARCIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "021042-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIN",
            "last_name": "STANDA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.