Brooke Marie Kalisiak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

70013529 Issued in MO

Practice address

2961 Dougherty Ferry Rd
Suite 105
Saint Louis, MO 63122-3374

Phone

(636) 225-3649

Fax

(888) 494-7074

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Washington University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Physical Therapy, LLCGroup PAC ID 6305903246, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Physical Therapy, LLC

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1245484849
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1164532198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 DOUGHERTY FERRY RD",
            "address_2": "SUITE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223374",
            "telephone_number": "636-225-3649",
            "fax_number": "888-494-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 DOUGHERTY FERRY RD",
            "address_2": "SUITE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223374",
            "telephone_number": "636-225-3649",
            "fax_number": "888-494-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISIAK",
        "first_name": "BROOKE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "70013529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuktesh Varma Kalidindi
• Rachel Kalina, LCSW
• Kristin Lee Kalinowski, MD
• Michael Eugene Kalinowski, MA LPC
• Katlin Kalish
• Kevin M Kalka, PTA
• Kelly Kallaos, OTR/L
• Michelle Patricia Kallis, M.D.
• Samuela Kallogjeri, OTR
• Melissa Gadsden Kaltenbach, M.D.

• Physical Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.