Individual provider Active NPI

Jennifer Katsirubas, PT

  • Orthopedic Physical Therapist
  • Broomfield, CO
National Provider Identifier
1386196848
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PTL.0014361 Issued in CO
Practice address
325 Interlocken Pkwy
Broomfield, CO 80021-3497
Phone
(303) 460-0329
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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 PTL.0014361 CO Primary

Addresses

Primary practice location

325 Interlocken Pkwy
Broomfield, CO 80021-3497

Mailing address

14029 Crestone Cir
Broomfield, CO 80023-3949
Phone (508) 353-6146

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170206001848 CO Practitioner - Physical Therapist in Private Practice 0143503763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Physical Therapy, P.C. Orthopedic CurrentSince Nov 3, 2016 Accepting new patients

Locations

590 Burbank St
Unit 205
Broomfield, CO 80020
Phone (303) 460-0329

325 Interlocken Pkwy
Ste A100
Broomfield, CO 80021
Phone (303) 460-0329

Organizations & group practices 1

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": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1386196848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14029 CRESTONE CIR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233949",
            "telephone_number": "508-353-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 INTERLOCKEN PKWY",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213497",
            "telephone_number": "303-460-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSIRUBAS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CO",
            "license": "PTL.0014361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.