Active NPI
Kristie Lynn Karelus, P.T.
- Physical Therapist
- Fairport, NY
National Provider Identifier
1093850158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 021627-1
- Practice address
- 41 Oconnor Rd
Fairport, NY 14450-1327 - Phone
- (585) 377-4660
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 021627-1 | NY | Primary |
Addresses
Primary practice location
41 Oconnor Rd
Fairport, NY 14450-1327
Mailing address
41 Oconnor Rd
Fairport, NY 14450-1327
Phone (585) 377-4660
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7702288 | Other | MVP | |
| P010021627 | Other | MONROE PLAN | |
| P010021627 | Other | BLUE CROSS BLUE SHIELD | |
| RC62021627 | Other | RICPA | |
| 7824392 | Other | AETNA | |
| P010021627 | Other | RIPA | |
| P010021627 | Other | BLUE CHOICE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021627-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1093850158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 OCONNOR RD",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144501327",
"telephone_number": "585-377-4660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 OCONNOR RD",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144501327",
"telephone_number": "585-377-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KARELUS",
"first_name": "KRISTIE",
"middle_name": "LYNN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "021627-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "7702288",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MONROE PLAN",
"identifier": "P010021627",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P010021627",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RICPA",
"identifier": "RC62021627",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7824392",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RIPA",
"identifier": "P010021627",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "P010021627",
"state": null
}
],
"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 Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.