Active NPI
Thomas James Krisko, PTA
- Physical Therapy Assistant
- La Quinta, CA
National Provider Identifier
1144815663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 51036
- Practice address
- 79440 Corporate Center Dr Ste 112
La Quinta, CA 92253-7243 - Phone
- (760) 771-9054
- NPI assigned
- Mar 5, 2021
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 51036 | CA | Primary |
Addresses
Primary practice location
79440 Corporate Center Dr Ste 112
La Quinta, CA 92253-7243
Mailing address
118 Rosetta CT
Palm Desert, CA 92211-0773
Phone (619) 592-0142
Other practice location 1
77622 Country Club Dr Ste G
Palm Desert, CA 92211-0447
Phone (760) 345-3087
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 |
|---|---|---|---|
| 51036 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614902400000",
"number": "1144815663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 ROSETTA CT",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922110773",
"telephone_number": "619-592-0142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79440 CORPORATE CENTER DR STE 112",
"city": "LA QUINTA",
"state": "CA",
"postal_code": "922537243",
"telephone_number": "760-771-9054"
}
],
"practiceLocations": [
{
"address_1": "77622 Country Club Dr Ste G",
"address_purpose": "LOCATION",
"city": "Palm Desert",
"state": "CA",
"postal_code": "922110447",
"country_code": "US",
"telephone_number": "760-345-3087",
"fax_number": "760-345-6852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRISKO",
"first_name": "THOMAS",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-05",
"last_updated": "2021-03-05",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "51036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Quinta, CA
- George Henry Koenig, M.D.
- Stephanie D Kolsrud, RDN
- Kondovski Medical Group
- Alexander Korn, M.D.
- Koushan Siami M D a Professional Corporation
- Kristen Bohnet, DC, Lac, Acupuncture Corporation (Bohnet Acupuncture and Chiropractic)
- Debra J Kuracina, M.D.
- La Quinta Care
- La Quinta Ear Nose & Throat, Inc.
- La Quinta Kidney Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.