Kelly D Kovacic, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

09059 Issued in OH

Practice address

17 E River St Ste a
Newton Falls, OH 44444-1372

Phone

(330) 872-7242

NPI assigned

Nov 9, 2005

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tudor Home Therapies IncGroup PAC ID 1850290644, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tudor Home Therapies Inc

  • Physical Therapist
  • Austintown, OH
  • NPI 1295783389
  Medicare reassignment Care Compare group NPD
• Tu Dor Home Therapies Inc

  • Physical Therapist
  • Boardman, OH
  • NPI 1164470233
  NPD (past)
• Tu Dor Home Therapies Inc

  • Physical Therapist
  • Newton Falls, OH
  • NPI 1164603320
  NPD (past)
• Tudor Home Therapies Inc

  • Physical Therapist
  • Youngstown, OH
  • NPI 1063847747
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1215918909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392573",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152514084",
            "telephone_number": "724-343-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E RIVER ST STE A",
            "city": "NEWTON FALLS",
            "state": "OH",
            "postal_code": "444441372",
            "telephone_number": "330-872-7242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1397 S Canfield Niles Rd",
            "address_2": "Unit 1",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445154084",
            "country_code": "US",
            "telephone_number": "330-953-0129",
            "fax_number": "330-953-0650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7645 Market St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445126098",
            "country_code": "US",
            "telephone_number": "330-965-9330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4451 Mahoning Ave NW Ste A",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444831977",
            "country_code": "US",
            "telephone_number": "330-372-0207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2860 Canfield Rd",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445112803",
            "country_code": "US",
            "telephone_number": "330-799-6298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 E State Route 14 Ste B001",
            "address_purpose": "LOCATION",
            "city": "Columbiana",
            "state": "OH",
            "postal_code": "444088490",
            "country_code": "US",
            "telephone_number": "330-482-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOVACIC",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "09059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "6500222996",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000198483",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2278762",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Reagan E Kilpatrick, CDCA
• Liane King
• Cassidy Kirven
• Madison Kiser
• Gabriel Kovach
• Brian Fredrick Kurtz
• Esperanza Micaela Kurtz
• Sophie A Kurtz
• Michael Jon Langdon, RPH
• Laurie Ann Home Health Care, Inc

• Physical Therapist in Newton Falls, OH
• Providers in Newton Falls, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.