Kristin Marie Maccanico, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8183 Issued in MA

Practice address

2150 S Eastern Ave
Las Vegas, NV 89104-4109

Phone

(702) 207-0842

Fax

(702) 207-0357

NPI assigned

Jun 2, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760745600000",
    "number": "1144514563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044109",
            "telephone_number": "702-207-0842",
            "fax_number": "702-207-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044109",
            "telephone_number": "702-207-0842",
            "fax_number": "702-207-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCANICO",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "8183",
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren Macaspac
• Glovanni Bomediano Macatao
• Melissa Macato
• Bryan Macatuno
• Michael Macayan, PTA
• Elizabeth Alessandra Maccato, MD
• Ryan Andrew Macclary
• Kayleigh Macconnell, LMSW, CSW-INTERN
• Heather Macdavid
• Joshua Macdavid, M.D.

• Physical Therapy Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapy Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2025; 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.