Individual provider Active NPI

Kurtis Hallam

  • Orthopedic Physical Therapist
  • Roseville, CA
National Provider Identifier
1285023341
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT42126 Issued in CA
Practice address
1620 Lead Hill Blvd
Roseville, CA 95661-2853
Phone
(916) 789-1111
NPI assigned
Jan 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT42126 CA Primary

Addresses

Primary practice location

1620 Lead Hill Blvd
Roseville, CA 95661-2853

Mailing address

1620 Lead Hill Blvd
Roseville, CA 95661-2853
Phone (916) 789-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150318000356 CA Practitioner - Physical Therapist in Private Practice 5698092328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1535 River Park Dr
Suite 1000
Sacramento, CA 95815-4601
Phone (916) 286-1000

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42126CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swanson Schaack Physical Therapy Orthopedic CurrentSince Nov 11, 2015 Accepting new patients
Regents of the University of California CurrentSince Feb 24, 2021 Accepting new patients
Schaack Physical Therapy PC CurrentSince Nov 11, 2015 Accepting new patients
The Physical Therapy Clinics, Inc. PastSince Jan 5, 2015 Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

2330 E Bidwell St
Ste 130
Folsom, CA 95630

111 Woodmere Rd
Ste 270
Folsom, CA 95630

801 Sterling Pkwy
Ste 150
Lincoln, CA 95648
Phone (916) 543-7900

1620 Lead Hill Blvd
Ste 200
Roseville, CA 95661
Phone (916) 789-1111

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

4860 Y St
Ste 1700
Sacramento, CA 95817
Phone (916) 734-2700

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

1535 River Park Dr
Ste 1000
Sacramento, CA 95815
Phone (916) 286-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1285023341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 LEAD HILL BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612853",
            "telephone_number": "916-789-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 LEAD HILL BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612853",
            "telephone_number": "916-789-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAM",
        "first_name": "KURTIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-13",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT42126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.