Individual provider Active NPI

Vadim Kipiller, PT

  • Physical Therapist
  • Pittsburgh, PA
National Provider Identifier
1205015252
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045495 Issued in NY
Practice address
1110 Greenfield Ave
Pittsburgh, PA 15217-2931
Phone
(412) 417-1901
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 045495 NY Primary
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X PT015287 PA

Addresses

Primary practice location

1110 Greenfield Ave
Pittsburgh, PA 15217-2931

Mailing address

1110 Greenfield Ave
Pittsburgh, PA 15217-2931
Phone (412) 417-1901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200709002806 NY Practitioner - Physical Therapist in Private Practice 7618067885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3047 Ave U
Brooklyn, NY 11229

Merit-based Incentive Payment System (MIPS)

Final score
21.32 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015287PAMDNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
045495NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physical Therapy Services PC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients
A to Z PT Rehab PC Single Specialty CurrentSince Feb 1, 2021 Accepting new patients
New York Physical and Occupational Therapy Services, PLLC Single Specialty CurrentSince Jun 29, 2020 Accepting new patients
East Suburban Home Care LLC Single Specialty Past Accepting new patients

Locations

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

Organizations & group practices 5

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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1205015252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 GREENFIELD AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172931",
            "telephone_number": "412-417-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 GREENFIELD AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172931",
            "telephone_number": "412-417-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPILLER",
        "first_name": "VADIM",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045495",
            "primary": true
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "PA",
            "license": "PT015287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.