Individual provider Active NPI

Kristen Gabrielle Tetro

  • Physical Therapy Assistant
  • Massapequa, NY
National Provider Identifier
1225983232
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
015031 Issued in NY
Practice address
5700 Merrick Rd
Massapequa, NY 11758-6221
Phone
(516) 798-9605
NPI assigned
Mar 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 015031 NY Primary

Addresses

Primary practice location

5700 Merrick Rd
Massapequa, NY 11758-6221

Mailing address

5700 Merrick Rd
Massapequa, NY 11758-6221
Phone (516) 798-9605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
015031NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1225983232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586221",
            "telephone_number": "516-798-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586221",
            "telephone_number": "516-798-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRO",
        "first_name": "KRISTEN",
        "middle_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "015031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.