Individual provider Active NPI

Kristin Julie De Jong, MSPT

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1053522995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16756 Issued in MA
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

Updated by the provider on Jul 8, 2007

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 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

Enrollment IDStateProvider typePAC IDDetails
I20241230002327 MA Practitioner - Physical Therapist in Private Practice 9537696711 Reassigns benefits to 1 organization

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
Dufer LLCGroup PAC ID 9032356423, 12 clinicians

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

LicenseStateTypeSpecialty
16756MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dufer LLC Physical Therapist CurrentSince Dec 30, 2024 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.

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.

Verify at the official NPI Registry.