Individual provider Active NPI

Kristina Arlene Wolff, DPT

  • Physical Therapist
  • St Louis Park, MN
National Provider Identifier
1083902159
Registry record updated Jul 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8834 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone
(952) 993-5900
Fax
(952) 993-5585
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360 Physical Therapy LLC 87 clinicians

Practice addresses (Care Compare)

4210 E Baseline Rd
Suite 106
Mesa, AZ 85206-4418
Phone (480) 503-2373

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20220926001866 AZ Practitioner - Physical Therapist in Private Practice 7416127352 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
360 Physical Therapy, LLC CurrentSince Aug 3, 2022 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients
360 Physical Therapy LLC Physical Therapist CurrentSince Aug 3, 2022 Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

1472 E Williams Field Rd
Ste 100
Gilbert, AZ 85295

4210 E Baseline Rd
Ste 106
Mesa, AZ 85206
Phone (480) 503-2373

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8834 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426-4702

Mailing address

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-5900

Other names 1

NPPES NPI Registry
  • Kristina Arlene Van Skike Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2011.

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311465600000",
    "number": "1083902159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-5900",
            "fax_number": "952-993-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264702",
            "telephone_number": "952-993-5900",
            "fax_number": "952-993-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "KRISTINA",
        "middle_name": "ARLENE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "VAN SKIKE",
            "middle_name": "ARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2011; 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.