Individual provider Active NPI

Janis Konkle

  • Physical Therapist
  • Hyannis, MA
National Provider Identifier
1205485273
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24504 Issued in MA
Practice address
905 Attucks LN
Hyannis, MA 02601-8146
Phone
(508) 771-9600
NPI assigned
Sep 11, 2019
Last updated
Sep 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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 24504 MA Primary

Addresses

Primary practice location

905 Attucks LN
Hyannis, MA 02601-8146

Mailing address

949 Liberty Square Rd
Boxborough, MA 01719-1139
Phone (978) 290-8949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200908000748 SC Practitioner - Physical Therapist in Private Practice 1456789379 Reassigns benefits to 1 organization
I20231031001021 CA Practitioner - Physical Therapist in Private Practice 1456789379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
New York Medical College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monterey Spine and Joint PCGroup PAC ID 0840295721, 75 clinicians

Practice addresses (Care Compare)

21 Lower Ragsdale Dr
Monterey, CA 93940-5827
Phone (831) 648-7200

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
57.41
Promoting interoperability
100
Improvement activities
40
Cost
80.4

Merit-based Incentive Payment System (MIPS)

Final score
73.77 of 100Reported as group
Quality
31.85
Promoting interoperability
98
Improvement activities
40
Cost
82.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10014SCMDDentist
24504MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Apr 8, 2024 Accepting new patients
Monterey Spine & Joint PC CurrentSince Nov 24, 2024 Accepting new patients
Monterey Spine & Joint PC CurrentSince Nov 24, 2024 Accepting new patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Apr 8, 2024 Accepting new patients
Montage Surgical Group Past Accepting new patients

Locations

12 Upper Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6060

21 Lower Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6040

1076 Ribaut Rd
Ste 101
Beaufort, SC 29902
Phone (843) 525-0045

1076 Ribaut Rd
Ste 102
Beaufort, SC 29902
Phone (843) 521-1970

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1205485273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 LIBERTY SQUARE RD",
            "city": "BOXBOROUGH",
            "state": "MA",
            "postal_code": "017191139",
            "telephone_number": "978-290-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 ATTUCKS LN",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026018146",
            "telephone_number": "508-771-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKLE",
        "first_name": "JANIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.