Individual provider Active NPI

Kirsten Mae Brown, PT, DPT

  • Physical Therapist
  • Solana Beach, CA
National Provider Identifier
1386990943
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20049 Issued in MA
Practice address
560 Stevens Ave
Solana Beach, CA 92075
Phone
(781) 831-2074
NPI assigned
Jul 31, 2012
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20049 MA Primary

Addresses

Primary practice location

560 Stevens Ave
Solana Beach, CA 92075

Mailing address

PO Box 22338
San Diego, CA 92192
Phone (781) 831-2074

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140627000012 CA Practitioner - Physical Therapist in Private Practice 9931324340 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20049MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jan 14, 2022 Accepting new patients
Water and Sports Physical Therapy, Inc Physical Therapist CurrentSince Jan 27, 2014 Accepting new patients
Water and Sports Physical Therapy Past Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

3535 General Atomics Ct
San Diego, CA 92121
Phone (858) 724-0392

3639 Midway Dr
#B286
San Diego, CA 92110

3639 Midway Dr
Ste B286
San Diego, CA 92110
Phone (858) 724-1747

501 W Broadway
San Diego, CA 92101
Phone (619) 237-9027

9875 Aviary Dr
San Diego, CA 92131

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1386990943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22338",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92192",
            "telephone_number": "781-831-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "92075",
            "telephone_number": "781-831-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIRSTEN",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solana Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.