Individual provider Active NPI

Kristine Elizabeth Mazur

  • Physical Therapist
  • North East, PA
National Provider Identifier
1437512019
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT025104 Issued in PA
Practice address
10680 W Main Rd
North East, PA 16428-2226
Phone
(814) 490-6456
NPI assigned
Apr 1, 2016
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 PT025104 PA Primary

Addresses

Primary practice location

10680 W Main Rd
North East, PA 16428-2226

Mailing address

10680 W Main Rd
North East, PA 16428-2226
Phone (814) 725-4808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212003297 PA Practitioner - Physical Therapist in Private Practice 2163958273 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Oct 7, 2024 Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Physical Therapist Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Oct 7, 2024 Accepting new patients

Locations

352 Railroad St
Ligonier, PA 15658
Phone (724) 238-3301

1012 Water St
Meadville, PA 16335
Phone (814) 333-2001

10680 W Main Rd
North East, PA 16428
Phone (814) 490-6456

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1437512019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10680 W MAIN RD",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164282226",
            "telephone_number": "814-725-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10680 W MAIN RD",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164282226",
            "telephone_number": "814-490-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "KRISTINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.