Individual provider Active NPI

Kaitlin Dobrowolski, PT, DPT

  • Physical Therapist
  • Titusville, FL
National Provider Identifier
1336861822
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39413 Issued in FL
Practice address
2210 Cheney Hwy
Titusville, FL 32780-6702
Phone
(321) 268-6111
NPI assigned
Sep 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X FL
Physical Therapist 225100000X 39413 FL Primary

Addresses

Primary practice location

2210 Cheney Hwy
Titusville, FL 32780-6702

Mailing address

1115 Moore Ave
Cheboygan, MI 49721
Phone (231) 290-2444

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
39413FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cora Health Services Inc PastSince Sep 1, 2022 Accepting new patients
Cora Health Services, Inc PastSince Sep 1, 2022 Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1336861822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 MOORE AVE",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "49721",
            "telephone_number": "231-290-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 CHENEY HWY",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806702",
            "telephone_number": "321-268-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBROWOLSKI",
        "first_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "39413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.