Kyle S McIntyre

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02179900 Issued in NJ

Practice address

230 N Maple Ave Ste B10
Marlton, NJ 08053-9423

Phone

(856) 396-2500

Fax

(856) 396-2525

NPI assigned

Jun 14, 2023

Last updated

Jun 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Restore Physical Therapy, LLCGroup PAC ID 8820096860, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Restore Physical Therapy, LLC

  • Physical Therapist
  • Marlton, NJ
  • NPI 1174531842
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1407530017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MAPLE AVE STE B10",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539423",
            "telephone_number": "856-396-2500",
            "fax_number": "856-396-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MAPLE AVE STE B10",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539423",
            "telephone_number": "856-396-2500",
            "fax_number": "856-396-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "KYLE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02179900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dene McGinnis Grinnell, MSN APRN FNP-C
• Jessica Marie McGoldrick
• Thomas McGowan Jr., LPC
• Karie Jean McGuire, LCSW
• Bryan J McIntyre, DO
• Candace R McKay, M.A., N.C.C., L.P.C.
• Camille S McKenzie, LCSW
• Veronica McKithen, LPC
• Francis Albert McLaughlin, APN
• Patrick McMahon, M.D.

• Physical Therapist in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.