Kristin Diane Wodzinski Andreae, MS, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501011205 Issued in MI

Practice address

1455 W Fair Ave
Marquette, MI 49855-2654

Phone

(616) 460-0689

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Superior Active Partners LLC 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Superior Active Partners LLC

  • Physical Therapy Clinic/Center
  • Ishpeming, MI
  • NPI 1982045001

  MI, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Marquette Rehabilitation & Sports Medicine Center

  • Physical Therapy Clinic/Center
  • Marquette, MI
  • NPI 1376771287

  MI, Physical Therapist

  Medicare reassignment NPD
• William Sterling Margaret LLC

  • Physical Therapist
  • Novi, MI
  • NPI 1003946625
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1205966165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 W FAIR AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552654",
            "telephone_number": "616-460-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 W FAIR AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552654",
            "telephone_number": "616-460-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREAE",
        "first_name": "KRISTIN",
        "middle_name": "DIANE WODZINSKI",
        "name_prefix": "Miss",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "0E20191",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PT",
            "identifier": "0E20057",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Amour
• Amanda Kay Anderson
• Hanna Anderson
• Jeanie Marie Anderson
• Lauren E Anderson, LLMSW
• Riley Andridge, DNP
• Anesthesiology of Marquette, P.C.
• Angela K. Palomaki, D.D.S., P.C.
• Annie Skewis, LLC
• Annie Skewis, LLC

• All providers in Marquette, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.