Active NPI
Kristin Julie De Jong, MSPT
- Physical Therapist
- Boston, MA
National Provider Identifier
1053522995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16756
- Practice address
- 800 Washington St
Boston, MA 02111 - Phone
- (617) 636-5000
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16756 | MA | Primary |
Addresses
Primary practice location
800 Washington St
Boston, MA 02111
Mailing address
14 Whittemore Rd
Newton, MA 02458-2106
Phone (617) 308-1880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Boston University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
235 Cypress St
Suite 110
Brookline, MA 02445-6777
Phone (617) 860-6430
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16756 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dufer LLC | Physical Therapist | Current | Accepting new patients |
Locations
25 Drydock Ave
Boston, MA 02210
Phone (617) 266-0323
235 Cypress St
Ste 110
Brookline, MA 02445
Phone (617) 860-6430
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 and National Provider Directory roles.
-
- Orthopedic Physical Therapist
- Brookline, MA
- NPI 1053659532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053522995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WHITTEMORE RD",
"city": "NEWTON",
"state": "MA",
"postal_code": "024582106",
"telephone_number": "617-308-1880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "617-636-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JONG",
"first_name": "KRISTIN",
"middle_name": "JULIE",
"name_prefix": "Ms.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "16756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.