Individual provider Active NPI

Kaylee Ann Chavarria, DPT

  • Physical Therapist
  • Fairfield, CA
National Provider Identifier
1154923688
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299365 Issued in CA
Practice address
222 Acacia St
Fairfield, CA 94533-3800
Phone
(707) 421-2095
Fax
(707) 434-9725
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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 299365 CA Primary

Addresses

Primary practice location

222 Acacia St
Fairfield, CA 94533-3800

Mailing address

222 Acacia St
Fairfield, CA 94533-3800
Phone (707) 421-2095

Other identifiers 1

IdentifierTypeStateIssuer
299365OtherCAPHYSICAL THERAPY OF CALIFORNIA PT LICENCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223002128 CA Practitioner - Physical Therapist in Private Practice 4486066032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Senior Living LLCGroup PAC ID 0446754451, 117 clinicians
Body in Balance Physical Therapy IncGroup PAC ID 6608857909, 8 clinicians

Practice addresses (Care Compare)

1111 Alvarado Ave
Davis, CA 95616-5918
Phone (530) 200-8315

222 Acacia St
Fairfield, CA 94533-3800
Phone (707) 421-0418

Merit-based Incentive Payment System (MIPS)

Final score
75.98 of 100Reported as group
Quality
55.25
Improvement activities
40
Cost
79.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Body in Balance Physical Therapy, Inc. Physical Therapist CurrentSince Nov 11, 2020 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Nov 11, 2020 Accepting new patients

Locations

222 Acacia St
Fairfield, CA 94533
Phone (707) 421-0418

1009 Alamo Dr
Vacaville, CA 95687
Phone (707) 689-5025

Organizations & group practices 3

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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1154923688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 ACACIA ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333800",
            "telephone_number": "707-421-2095",
            "fax_number": "707-434-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ACACIA ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333800",
            "telephone_number": "707-421-2095",
            "fax_number": "707-434-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVARRIA",
        "first_name": "KAYLEE",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY OF CALIFORNIA PT LICENCE",
            "identifier": "299365",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.