Individual provider Active NPI

Kelsey Catherine McClurg

  • Physical Therapist
  • Santa Cruz, CA
National Provider Identifier
1124532585
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT293618 Issued in CA
Practice address
8030 Soquel Ave
Santa Cruz, CA 95062-2096
Phone
(831) 295-6735
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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 PT293618 CA Primary

Addresses

Primary practice location

8030 Soquel Ave
Santa Cruz, CA 95062-2096

Mailing address

3804 Meadow Rd
South Lake Tahoe, CA 96150-8924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180223002471 CA Practitioner - Physical Therapist in Private Practice 0143581629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Physical Therapy and FitnessGroup PAC ID 9234435215, 11 clinicians

Practice addresses (Care Compare)

8030 Soquel Ave
Suite 200
Santa Cruz, CA 95062-2096
Phone (831) 464-8200

Merit-based Incentive Payment System (MIPS)

Final score
27.51 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
91.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT293618CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Physical Therapy & Fitness Physical Therapist CurrentSince Dec 1, 2017 Accepting new patients

Locations

8030 Soquel Ave
Ste 200
Santa Cruz, CA 95062
Phone (831) 464-8200

Organizations & group practices 1

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1124532585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 MEADOW RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961508924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622096",
            "telephone_number": "831-295-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURG",
        "first_name": "KELSEY",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT293618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.