Individual provider Active NPI

Kimberly Sue Wah, D.P.T.

  • Physical Therapist
  • Royal Palm Beach, FL
National Provider Identifier
1053549154
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22423 Issued in FL
Practice address
11947 Southern Blvd
Royal Palm Beach, FL 33411
Phone
(561) 204-2213
Fax
(561) 204-2218
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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 22423 FL Primary

Addresses

Primary practice location

11947 Southern Blvd
Royal Palm Beach, FL 33411

Mailing address

11947 Southern Blvd
Royal Palm Beach, FL 33411-7619
Phone (561) 204-2213

Other practice location 1

5026-B N. Federal Hwy
Lighthouse Point, FL 33064
Phone (954) 426-8884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014001279 FL Practitioner - Physical Therapist in Private Practice 7012226046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.65 of 100Reported as group
Quality
66.27
Promoting interoperability
100
Improvement activities
40
Cost
72.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22423FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chomsky Therapy Services Inc. Physical Therapist CurrentSince Jul 6, 2015 Accepting new patients
Tenet Florida Physician Services II, LLC Physical Therapist CurrentSince Jun 30, 2020 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Jun 30, 2020 Accepting new patients
Atlantic Rehabilitation Inc Physical Therapist PastSince Jan 1, 2000 Accepting new patients

Locations

6609 Woolbright Rd
Ste 420
Boynton Beach, FL 33437
Phone (561) 200-4262

6609 W Woolbright Rd
#P
Boynton Beach, FL 33437
Phone (561) 200-4262

3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

5325 Greenwood Ave
Ste 304
West Palm Beach, FL 33407
Phone (321) 840-1960

Interoperability endpoints

  • Direct secure messaging: kimberly.wah.1@13023.direct.athenahealth.com

Organizations & group practices 4

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1053549154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11947 SOUTHERN BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117619",
            "telephone_number": "561-204-2213",
            "fax_number": "561-204-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11947 SOUTHERN BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "33411",
            "telephone_number": "561-204-2213",
            "fax_number": "561-204-2218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5026-B N. Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Lighthouse Point",
            "state": "FL",
            "postal_code": "33064",
            "country_code": "US",
            "telephone_number": "954-426-8884",
            "fax_number": "954-426-8885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAH",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "22423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.