Individual provider Active NPI

Andrew Kafka, PT, DPT

  • Physical Therapist
  • Post Falls, ID
National Provider Identifier
1205417433
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1132 E Polston Ave
Post Falls, ID 83854-6045
Phone
(208) 777-7800
Fax
(208) 777-9209
NPI assigned
Apr 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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 Primary

Addresses

Primary practice location

1132 E Polston Ave
Post Falls, ID 83854-6045

Mailing address

1132 E Polston Ave
Post Falls, ID 83854-6045
Phone (208) 777-7800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trish@rivercitypt.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621003156 MT Practitioner - Physical Therapist in Private Practice 7517367352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Active Physical Therapy and Sports Injury Center LLCGroup PAC ID 5799709523, 4 clinicians

Practice addresses (Care Compare)

1410 S Reserve St
Missoula, MT 59801-4758
Phone (406) 829-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Physical Therapy & Sports Injury Center, LLC Physical Therapist CurrentSince May 23, 2023 Accepting new patients

Locations

1410 S Reserve St
Missoula, MT 59801
Phone (406) 327-0234

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1205417433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-777-7800",
            "fax_number": "208-777-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-777-7800",
            "fax_number": "208-777-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAFKA",
        "first_name": "ANDREW",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trish@rivercitypt.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email through our website",
            "address_1": "1132 E Polston Ave",
            "city": "Post Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838546045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.