Individual provider Active NPI

Kristen Smith, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1083132039
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5101 Issued in AZ
Practice address
6320 N la Cholla Blvd Ste 310
Tucson, AZ 85741-3552
Phone
(520) 382-8200
Fax
(520) 297-3505
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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 5101 NM
Physical Therapist 225100000X 5101 AZ Primary

Addresses

Primary practice location

6320 N la Cholla Blvd Ste 310
Tucson, AZ 85741-3552

Mailing address

PO Box 31630
Tucson, AZ 85751-1630
Phone (520) 784-6200

Other identifiers 1

IdentifierTypeStateIssuer
528608MedicaidAZ

Other names 1

  • Kristen Patenaude Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171023000023 NM Practitioner - Physical Therapist in Private Practice 7719251321 Reassigns benefits to 1 organization
I20190705000616 AZ Practitioner - Physical Therapist in Private Practice 7719251321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6320 N la Cholla Blvd
Suite 310
Tucson, AZ 85741-3552
Phone (520) 382-8200

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5101AZMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Orthopaedic Institute Professional Corporation Physical Therapist CurrentSince Oct 22, 2021 Accepting new patients
Tucson Orthopaedic Institute Professional Corporation Physical Therapist CurrentSince Oct 22, 2021 Accepting new patients
Socorro Physical Therapy Incorporated Physical Therapist CurrentSince Jul 26, 2017 Accepting new patients

Locations

2424 N Wyatt Dr
Ste 130
Tucson, AZ 85712
Phone (520) 784-6570

6320 N La Cholla Blvd
Ste 310
Tucson, AZ 85741
Phone (520) 219-9125

6320 N La Cholla Blvd
Ste 200
Tucson, AZ 85741

911 N California St
Socorro, NM 87801
Phone (575) 838-1000

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": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1083132039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31630",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511630",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 N LA CHOLLA BLVD STE 310",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413552",
            "telephone_number": "520-382-8200",
            "fax_number": "520-297-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "5101",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528608",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "PATENAUDE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.