Individual provider Active NPI

Katelyn Sidoti

  • Physical Therapist
  • Laveen, AZ
National Provider Identifier
1043041320
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5911 W Baseline Rd Ste 102
Laveen, AZ 85339-2811
Phone
(480) 281-6103
NPI assigned
Aug 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305216694 VA
Physical Therapist 225100000X PTL28158 MA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

5911 W Baseline Rd Ste 102
Laveen, AZ 85339-2811

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

150 Burnetts Way Ste 230
Suffolk, VA 23434-8168
Phone (757) 942-2022

Other practice location 2

75-77 Spring Street
Unit 200
West Roxbury, MA 02132
Phone (617) 637-4640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MA, AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240905001136 VA Practitioner - Physical Therapist in Private Practice 7911447933 Reassigns benefits to 1 organization
I20250122002416 MA Practitioner - Physical Therapist in Private Practice 7911447933 Reassigns benefits to 1 organization
I20250916003999 AZ Practitioner - Physical Therapist in Private Practice 7911447933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

5911 W Baseline Rd
Suite 102
Laveen, AZ 85339-2811
Phone (480) 281-6103

75 Spring St
Suite 77
West Roxbury, MA 02132-4335
Phone (617) 637-4640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Jan 7, 2025 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Jul 25, 2025 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Jan 7, 2025 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

5911 W Baseline Rd
Ste 102
Laveen, AZ 85339
Phone (480) 281-6103

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

75 Spring St
#77
West Roxbury, MA 02132
Phone (617) 637-4640

75 Spring St
Unit 200
West Roxbury, MA 02132

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

150 Burnetts Way
Ste 230
Suffolk, VA 23434
Phone (757) 942-2022

Organizations & group practices 5

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1043041320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 W BASELINE RD STE 102",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392811",
            "telephone_number": "480-281-6103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Burnetts Way Ste 230",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348168",
            "country_code": "US",
            "telephone_number": "757-942-2022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75-77 Spring Street",
            "address_2": "Unit 200",
            "address_purpose": "LOCATION",
            "city": "West Roxbury",
            "state": "MA",
            "postal_code": "02132",
            "country_code": "US",
            "telephone_number": "617-637-4640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDOTI",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216694",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL28158",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.