Individual provider Active NPI

Kimberly Erin Zeladonis

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1164099735
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029516 Issued in PA
Practice address
6595B Roosevelt Blvd
Philadelphia, PA 19149-2918
Phone
(215) 743-2332
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 PT029516 PA Primary

Addresses

Primary practice location

6595B Roosevelt Blvd
Philadelphia, PA 19149-2918

Mailing address

6595B Roosevelt Blvd
Philadelphia, PA 19149-2918
Phone (215) 743-2332

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL KZeladonis@novacare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524003595 PA Practitioner - Physical Therapist in Private Practice 2860834512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VV Physiotherapy LLCGroup PAC ID 5698252591, 3 clinicians

Practice addresses (Care Compare)

2816 St Rd
Bensalem, PA 19020-2651
Phone (215) 447-9523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT029516PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 21, 2024 Accepting new patients

Locations

300 Welsh Rd
Bldg 1
Horsham, PA 19044

Organizations & group practices 2

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": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1164099735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595B ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492918",
            "telephone_number": "215-743-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595B ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492918",
            "telephone_number": "215-743-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELADONIS",
        "first_name": "KIMBERLY",
        "middle_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "KZeladonis@novacare.com",
            "affiliation": "N",
            "address_1": "6595B Roosevelt Blvd",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191492918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.