Kisten Dede, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2047 Issued in OR

Practice address

55 Coburg Rd
Eugene, OR 97401

Phone

(541) 485-8111

Fax

(541) 342-6379

NPI assigned

Oct 20, 2011

Sex

Female

Sole proprietor

Yes

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 OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Slocum Orthopedics PCGroup PAC ID 0547164758, 67 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Slocum Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Eugene, OR
  • NPI 1881694867
  Medicare reassignment Care Compare group NPD
• Slocum Orthopedics, PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Springfield, OR
  • NPI 1386146405

  Physical Therapist

  NPD

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1174808158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COBURG RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-485-8111",
            "fax_number": "541-342-6379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "999 Willamette St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974013112",
            "country_code": "US",
            "telephone_number": "541-687-9314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDE",
        "first_name": "KISTEN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Lammers Decalesta, O.D.
• Brett Decker
• Loraine X Decker
• Margaret Decordre
• Christine Leana Decroos
• Karyn Elizabeth Defoe, LPC
• Jenna Deford, NBC-HWC
• Melissa S Defreest, MD
• Allison A Defriez
• Sara Degler, PA-C

• Physical Therapist in Eugene, OR
• Providers in Eugene, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.