Individual provider Active NPI

Corey Kalish

  • Physical Therapy Assistant
  • Orange City, FL
National Provider Identifier
1033740246
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA29827 Issued in FL
Practice address
2884 Wellness Ave Ste 300
Orange City, FL 32763-8427
Phone
(386) 774-4404
NPI assigned
Jan 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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 PTA29827 FL Primary

Addresses

Primary practice location

2884 Wellness Ave Ste 300
Orange City, FL 32763-8427

Mailing address

514 Nantucket CT Apt 204
Altamonte Springs, FL 32714-2194

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
PTA29827FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cora Health Services Inc PastSince Feb 2, 2020 Accepting new patients
Cora Health Services, Inc PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 2

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": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1033740246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 NANTUCKET CT APT 204",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2884 WELLNESS AVE STE 300",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638427",
            "telephone_number": "386-774-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISH",
        "first_name": "COREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.