Individual provider Active NPI

Kayla Ann Corkum, DPT

  • Physical Therapist
  • Newton, MA
National Provider Identifier
1093589145
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL89006 Issued in MA
Practice address
100 Needham St FL 2
Newton, MA 02464-1500
Phone
(781) 444-5141
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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 PTL89006 MA Primary
Physical Therapist 225100000X 051410 NY

Addresses

Primary practice location

100 Needham St FL 2
Newton, MA 02464-1500

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

20 Walnut St Ste B
Montgomery, NY 12549-2261
Phone (845) 457-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231212000309 NY Practitioner - Physical Therapist in Private Practice 3577912914 Reassigns benefits to 2 organizations
I20251118002536 MA Practitioner - Physical Therapist in Private Practice 3577912914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

100 Needham St
FL 2
Newton, MA 02464-1500
Phone (978) 548-5384

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

20 Walnut St
Suite B
Montgomery, NY 12549-2261
Phone (845) 457-5555

78 Brookside Ave
Suite 144
Chester, NY 10918-1060
Phone (845) 469-2224

785 State Route 17M
Suite 16
Monroe, NY 10950-2629
Phone (845) 782-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL89006MAMDPhysical Therapist
051410NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Nov 4, 2025 Accepting new patients
Access PT, OT, New York, PLLC Physical Therapist CurrentSince Nov 8, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Nov 4, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Jun 30, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Jun 30, 2025 Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

100 Needham St
#2
Newton, MA 02464
Phone (781) 444-5141

111 E 210th St
Bronx, NY 10467

16 Maybrook Rd
Ste L
Campbell Hall, NY 10916

111 Maiden Ln
Kingston, NY 12401
Phone (845) 331-8590

20 Walnut St
Ste B
Montgomery, NY 12549
Phone (845) 457-5555

14 Thiells Mount Ivy Rd
Ste 2
Pomona, NY 10970
Phone (845) 694-8808

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1093589145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NEEDHAM ST FL 2",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641500",
            "telephone_number": "781-444-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Walnut St Ste B",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "NY",
            "postal_code": "125492261",
            "country_code": "US",
            "telephone_number": "845-457-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORKUM",
        "first_name": "KAYLA",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL89006",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "051410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.