South Jefferson Physical Therapy Pc is a medicare enrolled "Clinic/center - Physical Therapy" provider in Adams, New York. Their current practice location is
70 N Main St, Adams, New York. You can reach out to their office (for appointments etc.) via phone at
(315) 232-2225.
South Jefferson Physical Therapy Pc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. South Jefferson Physical Therapy Pc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1407930829.
Healthcare Provider's Profile
| Full Name | South Jefferson Physical Therapy Pc |
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| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 70 N Main St, Adams, New York |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1407930829
- Provider Enumeration Date: 10/24/2006
- Last Update Date: 12/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 8224205604
- Enrollment ID: O20120126000029
Medical Identifiers
Medical identifiers for South Jefferson Physical Therapy Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407930829 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 225200000X | Physical Therapy Assistant | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
South Jefferson Physical Therapy Pc acts as a billing entity for following providers:
| Provider Name | Barbara M Drake |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1609925759
PECOS PAC ID: 3971540659
Enrollment ID: I20050414000055 |
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| Provider Name | Heather A Miller |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1922199116
PECOS PAC ID: 4880792290
Enrollment ID: I20130808000393 |
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| Provider Name | Kelly A Gardner |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1184620478
PECOS PAC ID: 0749520443
Enrollment ID: I20190315000985 |
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| Provider Name | Emily Elizabeth Kolenda |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1043965486
PECOS PAC ID: 3072992072
Enrollment ID: I20220622001873 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. South Jefferson Physical Therapy Pc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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South Jefferson Physical Therapy Pc
70 N Main St,
Adams, NY 13605-3102
Ph: (315) 232-2225 | South Jefferson Physical Therapy Pc
70 N Main St,
Adams, NY 13605-3102
Ph: (315) 232-2225 |
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