Kristen Dacosta

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT40QA00773200 Issued in NJ

Practice address

54 N Park Ave
Shrewsbury, NJ 07702-4413

Phone

(917) 406-0478

NPI assigned

Jun 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pearl Rehabilitation LLC

  • Physical Medicine & Rehabilitation Physician
  • Shrewsbury, NJ
  • NPI 1225630122
  NPD
• Parker Creek Neurorehabilitation

  • Physical Therapy Clinic/Center
  • Little Silver, NJ
  • NPI 1740743467
  NPD (past)

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

{
    "created_epoch": "1623456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623456000000",
    "number": "1396313896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 KINGS HWY",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482023",
            "telephone_number": "173-269-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 N PARK AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024413",
            "telephone_number": "917-406-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-12",
        "last_updated": "2021-06-12",
        "certification_date": "2021-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NJ",
            "license": "PT40QA00773200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WebPT",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "54 N Park Ave",
            "city": "Shrewsbury",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077024413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandra Joan Cummings, PA-C
• Joseph M Cummings, CRNA
• Christina Cundari, PA
• Evan Curatolo, MD
• Current Pulse LLC
• Dale E. Edlin, MD, LLC
• Miguel Damien, M.D.
• Brian Peter Daniel, D.O.
• Shannon Danley, PT
• Christina David

• Pediatric Physical Therapist in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Pediatric Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.