Individual provider Active NPI

Kristiana Brady

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1194392308
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31762 Issued in AZ
Practice address
1702 S Val Vista Dr
Mesa, AZ 85204-7385
Phone
(480) 510-9451
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 LPT-31762 AZ Primary

Addresses

Primary practice location

1702 S Val Vista Dr
Mesa, AZ 85204-7385

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210617000267 AZ Practitioner - Physical Therapist in Private Practice 1254731912 Reassigns benefits to 3 organizations
I20221101002140 MA Practitioner - Physical Therapist in Private Practice 1254731912 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

1702 S Val Vista Dr
Suite 107
Mesa, AZ 85204-7386
Phone (480) 505-8140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31762AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC CurrentSince Jun 1, 2021 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Sep 12, 2022 Accepting new patients
Camelback Sports Therapy LLC Physical Therapist CurrentSince Oct 11, 2021 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Sep 14, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Sep 14, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Sep 12, 2022 Accepting new patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Apr 27, 2025 Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

2940 E Banner Gateway Dr
Ste 200
Gilbert, AZ 85234

2940 E Banner Gateway Dr
Ste 200250
Gilbert, AZ 85234

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

1702 S Val Vista Dr
Ste 107
Mesa, AZ 85204
Phone (480) 505-8140

1702 S Val Vista Dr
Mesa, AZ 85204
Phone (480) 510-9451

7707 W Deer Valley Rd
Ste 100
Peoria, AZ 85382
Phone (623) 376-9100

9069 W Olive Ave
Ste 105
Peoria, AZ 85345
Phone (623) 257-2079

4800 N 44th St
Phoenix, AZ 85018
Phone (602) 808-8989

3033 N 44th St
Ste 100
Phoenix, AZ 85018
Phone (602) 631-3161

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

100 E Camelback Rd
Ste 120
Phoenix, AZ 85012
Phone (602) 808-8989

40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

Organizations & group practices 9

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1194392308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S VAL VISTA DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047385",
            "telephone_number": "480-510-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "KRISTIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.