Individual provider Active NPI

Kristin Stewart, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1376728725
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10196 Issued in AZ
Practice address
4175 S Alamo Ave
Tucson, AZ 85707
Phone
(520) 228-2615
NPI assigned
Jan 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 029846 NY
Physical Therapist 225100000X 10196 AZ Primary

Addresses

Primary practice location

4175 S Alamo Ave
Tucson, AZ 85707

Mailing address

4175 S Alamo Ave
Tucson, AZ 85707-4405
Phone (520) 228-2615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131114002051 AZ Practitioner - Physical Therapist in Private Practice 3678709987 Reassigns benefits to 1 organization
I20250122001842 WA Practitioner - Physical Therapist in Private Practice 3678709987 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
Stanwood-Camano Physical Therapy PLLCGroup PAC ID 7012014236, 7 clinicians

Practice addresses (Care Compare)

9612 270TH St NW
Suite 103
Stanwood, WA 98292-1911
Phone (360) 629-8043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10196AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanwood-Camano Physical Therapy, PLLC Physical Therapist CurrentSince Dec 31, 2024 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients
360 Physical Therapy LLC Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients
360 Physical Therapy LLC Physical Therapist CurrentSince Apr 24, 2023 Accepting new patients
Vibrantcare Outpatient Rehabilitation West Inc PastSince Feb 19, 2023 Accepting new patients
Vibrantcare Outpatient Rehabilitation West Inc Past Accepting new patients
Physiotherapy Assoicates, Inc. PastSince Dec 31, 2024 Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

4022 E Greenway Rd
Ste 1
Phoenix, AZ 85032
Phone (480) 719-1644

21576 S Ellsworth Loop Rd
Ste 108
Queen Creek, AZ 85142
Phone (602) 737-2275

9612 270th St NW
Ste 103
Stanwood, WA 98292
Phone (360) 629-8043

Organizations & group practices 7

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": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1376728725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857074405",
            "telephone_number": "520-228-2615",
            "fax_number": "520-884-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85707",
            "telephone_number": "520-228-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KRISTIN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2022-02-09",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029846",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.