Kelli M Baruch, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT39615 Issued in CA

Practice address

12465 Lewis Street
Suite 101
Garden Grove, CA 92840-4658

Phone

(714) 703-8477

Fax

(714) 703-8157

NPI assigned

Jan 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelli M Crouse Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Physical Therapy IncGroup PAC ID 5597071860, 9 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.

• Ascend Physical Therapy, Inc

  • Physical Therapist
  • Garden Grove, CA
  • NPI 1184015943
  Medicare reassignment Care Compare group NPD
• Balance Rehabilitation, Inc.

  • Orthopedic Physical Therapist
  • Lake Forest, CA
  • NPI 1184734931
  Medicare reassignment NPD
• Innovative Management Inc

  • Physical Therapy Clinic/Center
  • Garden Grove, CA
  • NPI 1982722351
  NPD

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1346587631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12465 LEWIS STREET",
            "address_2": "SUITE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12465 LEWIS STREET",
            "address_2": "SUITE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARUCH",
        "first_name": "KELLI",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39615",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT39615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "CROUSE",
            "middle_name": "M",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Barrios, CADC II
• Elizabeth Barron
• Julie Bart
• Theresa Bartholomew
• Angela Bartolo
• Andre Barzegar, DSS
• Basem a Attum MD a Professional Corporation
• Rachel Bastone
• Jamie Baudek
• Patrice Ysabel Robey Bautista

• Orthopedic Physical Therapist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.