Individual provider Active NPI

Kailey Rebecca Kerstein, DPT

  • Physical Therapist
  • Thousand Oaks, CA
National Provider Identifier
1205439395
Registry record updated Oct 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT299390 Issued in CA
Practice address
137 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-5707
Phone
(805) 379-2132
Fax
(805) 917-4206
NPI assigned
Nov 19, 2020
Last updated
Oct 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 PT299390 CA Primary

Addresses

Primary practice location

137 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-5707

Mailing address

5720 Ralston St Ste 200
Ventura, CA 93003-7844
Phone (805) 804-4168

Other identifiers 1

IdentifierTypeStateIssuer
PT299390OtherCASTATE LICENSE

Other names 1

  • Kailey Rebecca Erickson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL venturaortho.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821003261 TX Practitioner - Physical Therapist in Private Practice 2567874456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista JV Partners LLCGroup PAC ID 3274998224, 126 clinicians

Practice addresses (Care Compare)

10150 Legacy Dr
Suite 100
Frisco, TX 75033-6730
Phone (214) 705-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT299390CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista JV Partners LLC Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
Amana Healthcare PLLC PastSince Dec 3, 2023 Accepting new patients

Locations

10150 Legacy Dr
Ste 100
Frisco, TX 75033
Phone (214) 705-8000

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, 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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664582400000",
    "number": "1205439395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 RALSTON ST STE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037844",
            "telephone_number": "805-804-4168",
            "fax_number": "805-830-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 E THOUSAND OAKS BLVD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605707",
            "telephone_number": "805-379-2132",
            "fax_number": "805-917-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSTEIN",
        "first_name": "KAILEY",
        "middle_name": "REBECCA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2022-10-01",
        "certification_date": "2022-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT299390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT299390",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "venturaortho.com",
            "affiliation": "N",
            "address_1": "137 E Thousand Oaks Blvd",
            "city": "Thousand Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913605707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAILEY",
            "last_name": "ERICKSON",
            "middle_name": "REBECCA",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.