Individual provider Active NPI

Kristine I Nylund, PT

  • Physical Therapist
  • Franklin Lakes, NJ
National Provider Identifier
1194923318
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00299800 Issued in NJ
Practice address
795 Franklin Ave
1St Floor
Franklin Lakes, NJ 07417-1368
Phone
(201) 847-8585
Fax
(201) 847-0985
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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 40QA00299800 NJ Primary

Addresses

Primary practice location

795 Franklin Ave
1St Floor
Franklin Lakes, NJ 07417-1368

Mailing address

4175 Veterans Memorial Hwy
Suite 202
Ronkonkoma, NY 11779-7639
Phone (631) 580-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004123NYMDMental Health Counselor
40QA00299800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Physical Therapy,LLC Physical Therapist Past Accepting new patients
Ivyrehab Network Inc. Physical Therapist Past Accepting new patients

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1194923318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 202",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797639",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 FRANKLIN AVE",
            "address_2": "1ST FLOOR",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171368",
            "telephone_number": "201-847-8585",
            "fax_number": "201-847-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYLUND",
        "first_name": "KRISTINE",
        "middle_name": "I",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00299800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.