Individual provider Active NPI

Stephen E Kush, P.T.

  • Physical Therapist
  • Scottsdale, AZ
National Provider Identifier
1063537843
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0274 Issued in AZ
Practice address
7331 E Osborn Dr
Suite 190
Scottsdale, AZ 85251-6435
Phone
(480) 874-4212
Fax
(480) 874-4917
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6496 NC
Physical Therapist 225100000X 0274 AZ Primary

Addresses

Primary practice location

7331 E Osborn Dr
Suite 190
Scottsdale, AZ 85251-6435

Mailing address

1844 E Baseline Rd
Suite C-5
Tempe, AZ 85283-1510
Phone (480) 833-1005

Other identifiers 1

IdentifierTypeStateIssuer
050766MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6496NCMDProfessional Counselor
0274AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Partners LLC Physical Therapist CurrentSince Jun 1, 2013 Accepting new patients
Petersen Physical Therapy PC PastSince Jan 1, 2004 Accepting new patients
Perfect Balance Physical Therapy, LLC Physical Therapist PastSince May 15, 2005 Accepting new patients

Locations

711 E Carefree Hwy
Ste 204
Phoenix, AZ 85085

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1063537843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 E BASELINE RD",
            "address_2": "SUITE C-5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831510",
            "telephone_number": "480-833-1005",
            "fax_number": "480-833-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7331 E OSBORN DR",
            "address_2": "SUITE 190",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516435",
            "telephone_number": "480-874-4212",
            "fax_number": "480-874-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSH",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6496",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "0274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050766",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.