Kristen Ferris Wentworth, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19862 Issued in MA

Practice address

439 Station Ave
South Yarmouth, MA 02664

Phone

(508) 394-3333

NPI assigned

Mar 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristen Fiola Former name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Proex Physical Therapy, LLC

  • Physical Therapist
  • Woburn, MA
  • NPI 1831190453
  Medicare reassignment Care Compare group
• Competitive Edge Physical Therapy & Sports Training, LLC

  • Physical Therapy Clinic/Center
  • Norwell, MA
  • NPI 1366502023

  Physical Therapist

  NPD (past)
• Proex Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • West Yarmouth, MA
  • NPI 1649023599
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1083988109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD STE PROEX",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 STATION AVE",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "02664",
            "telephone_number": "508-394-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Farm Glen Blvd",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321981",
            "country_code": "US",
            "telephone_number": "860-284-9780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Farm Glen Blvd",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321981",
            "country_code": "US",
            "telephone_number": "860-284-9780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "KRISTEN",
        "middle_name": "FERRIS",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009751",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "FIOLA",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in South Yarmouth, MA
• Providers in South Yarmouth, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.