Kaitlin Marie Mikkelsen, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

292767 Issued in CA

Practice address

6102 Avenida Encinas Ste G
Carlsbad, CA 92011-1005

Phone

(760) 884-0301

Fax

(760) 560-4285

NPI assigned

Feb 6, 2017

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 names 1

• Kaitlin Marie Maguire Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Seaside Performance Physical Therapy, Apc

  • Physical Therapy Clinic/Center
  • Carlsbad, CA
  • NPI 1700658408
  Medicare reassignment NPD Authorized official
• Empower Neurorehab

  • Rehabilitation Practitioner
  • San Diego, CA
  • NPI 1710602628

  Physical Therapist

  NPD

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1255879631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 SNAPDRAGON ST",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243346",
            "telephone_number": "858-717-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 AVENIDA ENCINAS STE G",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111005",
            "telephone_number": "760-884-0301",
            "fax_number": "760-560-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSEN",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-06",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "MAGUIRE",
            "middle_name": "MARIE",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Judith Jasmin Michel
• Michelle Moore PHD Inc. a Professional Psychological Corpora
• Rocio Middleton
• William Everett Middleton, LCSW
• Anna Mihai
• Elizabeth Rose Miles
• Brianna Millan
• Natalia Millan
• Miller Medical Associates of Nevada, PC
• James Miller

• Physical Therapist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.