Individual provider Active NPI

Kristina Lee Dimartino

  • Physical Therapist
  • Fairport, NY
National Provider Identifier
1093296758
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2154 Fairport Nine Mile PT Rd
Fairport, NY 14450-8743
Phone
(585) 364-1567
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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 NY Primary

Addresses

Primary practice location

2154 Fairport Nine Mile PT Rd
Fairport, NY 14450-8743

Mailing address

1842 Fairport Nine Mile Point Rd
Penfield, NY 14526-1904
Phone (631) 264-4589

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

NPI Registry JSON

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1093296758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 FAIRPORT NINE MILE POINT RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261904",
            "telephone_number": "631-264-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 FAIRPORT NINE MILE PT RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508743",
            "telephone_number": "585-364-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARTINO",
        "first_name": "KRISTINA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.