Kassidy Diaz, DPT
Individual provider Active NPI Physical Therapist · Middletown, DE
NPI 1124401534 · NPPES record last updated Mar 21, 2022
Key facts
- NPI
- 1124401534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- J1-0003367 (DE)
- Practice address
- 432 E Main St
Middletown, DE 19709-1462 - Phone
- (919) 258-2714
- Fax
- (410) 648-4878
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dynamic Therapy Services LLC
Practice addresses (Care Compare)
1401 Foulk Rd
Suite 2013
Wilmington, DE 19803-2763
Phone (302) 992-8351
1651-53 Pulaski Hwy
Bear, DE 19701-1453
Phone (302) 834-1550
432 E Main St
Middletown, DE 19709-1462
Phone (302) 376-4315
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.27 of 100
- Quality
- 85
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 73.4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150903001915 | DE | Practitioner - Physical Therapist in Private Practice | 5496061558 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT026076 | PA | MD | Orthotic Fitter |
| J1-0003367 | DE | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | PT026076 | PA | |
| Physical Therapist | 225100000X | J1-0003367 | DE | Yes |
Addresses
Primary practice location
432 E Main St
Middletown, DE 19709-1462
Mailing address
350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714
Other practice location 1
1265 Wayne Ave Ste 308
119 Professional Building
Indiana, PA 15701-3501
Phone (724) 801-8095 ext. 3515
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC44-0066 | Other | DE | CAREFIRST |
| 1124401534 | Medicaid | DE | |
| 3288895 | Other | DE | BS BS DE |
Other names
- Kassidy McLean
Other providers in Middletown, DE
- Rowena Descartes
- Alfonda Deseignora
- Jessica Lois Desrosiers
- Samuel Dewar
- Diamond State Surgical Associates,LLC
- Lisa Dickinson
- Dih Camp
- Divine Alignment Counseling & Coaching LLC
- Lorna A Divino
- Cameron Dixon
All providers in Middletown, DE · Physical Therapist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.