Individual provider Active NPI

Brian Michael Kedra, DPT

  • Physical Therapist
  • Doylestown, PA
National Provider Identifier
1366647703
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018889 Issued in PA
Practice address
73 Old Dublin Pike Ste 6
Doylestown, PA 18901-2491
Phone
(215) 489-1701
Fax
(215) 489-1705
NPI assigned
Jun 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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 J10002272 DE
Physical Therapist 225100000X PT018889 PA Primary

Addresses

Primary practice location

73 Old Dublin Pike Ste 6
Doylestown, PA 18901-2491

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other identifiers 8

IdentifierTypeStateIssuer
11796745OtherCAQH
2066834OtherPA BS
1366647703MedicaidDE
1366647703OtherTRICARE CHAMPUS
2872734000OtherAMERIHEALTH IBC
5070-0085OtherCARE FIRST
92830401OtherNCA
2872734000OtherIBC AMERIHEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080917000373 PA Practitioner - Physical Therapist in Private Practice 1254415995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

73 Old Dublin Pike
Suite 6
Doylestown, PA 18901-2491
Phone (215) 489-1701

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince May 1, 2008 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince May 1, 2008 Accepting new patients
Ati Holdings, LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

44 W Skippack Pike
Ambler, PA 19002
Phone (267) 419-2020

2641 Street Rd
Bensalem, PA 19020
Phone (267) 525-0135

73 Old Dublin Pike
Ste 6
Doylestown, PA 18901
Phone (215) 348-0666

511 S Oxford Valley Rd
Fairless Hills, PA 19030
Phone (215) 949-7985

190 Forty Foot Rd
Ste 110
Hatfield, PA 19440
Phone (267) 827-3079

1753 Kendarbren Dr
Ste 610
Jamison, PA 18929
Phone (215) 343-2141

2022 E Old Lincoln Hwy
Ste 6
Langhorne, PA 19047
Phone (215) 891-5150

7803 New Falls Rd
Ste B
Levittown, PA 19055
Phone (215) 949-7985

776 Bethlehem Pike
#2
Montgomeryville, PA 18936
Phone (267) 328-1310

770 Newtown Yardley Rd
Newtown, PA 18940
Phone (215) 860-2990

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

682 N West End Blvd
Quakertown, PA 18951
Phone (215) 892-1829

630 Easton Rd
Warrington, PA 18976
Phone (215) 491-5961

Organizations & group practices 3

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": "1182038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1366647703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 OLD DUBLIN PIKE STE 6",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012491",
            "telephone_number": "215-489-1701",
            "fax_number": "215-489-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDRA",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-17",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10002272",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11796745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BS",
            "identifier": "2066834",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366647703",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE CHAMPUS",
            "identifier": "1366647703",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH IBC",
            "identifier": "2872734000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "5070-0085",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCA",
            "identifier": "92830401",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC  AMERIHEALTH",
            "identifier": "2872734000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.