Individual provider Active NPI

Nathanael D Kloosterman, PT

  • Physical Therapist
  • Crown Point, IN
National Provider Identifier
1043571268
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05009699A Issued in IN
Practice address
1841 E Summit St
Crown Point, IN 46307-2768
Phone
(219) 801-7777
NPI assigned
Jun 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05009699A IN Primary

Addresses

Primary practice location

1841 E Summit St
Crown Point, IN 46307-2768

Mailing address

1841 E Summit St
Crown Point, IN 46307-2768
Phone (219) 801-7777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120628000484 IN Practitioner - Physical Therapist in Private Practice 5092970889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiopoint TherapyGroup PAC ID 2961626833, 8 clinicians

Practice addresses (Care Compare)

660 Morthland Dr
Suite D
Valparaiso, IN 46385-4638
Phone (219) 801-7777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05009699AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiopoint Therapy Physical Therapist CurrentSince May 1, 2014 Accepting new patients
Accelerated Rehabilitation Centers LTD Physical Therapist Past Accepting new patients
Hospice of America, Inc PastSince May 1, 2014 Accepting new patients

Locations

12636 Wicker Ave
Cedar Lake, IN 46303
Phone 2198017777 ext. 1

1841 E Summit St
Crown Point, IN 46307
Phone 2198017777 ext. 1

2050 45th St
Highland, IN 46322
Phone (219) 801-7777

660 Morthland Dr
Ste D
Valparaiso, IN 46385
Phone (219) 801-7777

Organizations & group practices 3

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1043571268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 E SUMMIT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072768",
            "telephone_number": "219-801-7777",
            "fax_number": "219-801-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 E SUMMIT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072768",
            "telephone_number": "219-801-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOSTERMAN",
        "first_name": "NATHANAEL",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009699A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.