Individual provider Active NPI

Krystel Martinez S Ko, PT

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1447933817
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039549-01 Issued in NY
Practice address
3520 Dekalb Ave Apt 5E
Bronx, NY 10467-1236
Phone
(551) 655-0743
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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 039549-01 NY Primary

Addresses

Primary practice location

3520 Dekalb Ave Apt 5E
Bronx, NY 10467-1236

Mailing address

3520 Dekalb Ave Apt 5E
Bronx, NY 10467-1236
Phone (551) 655-0743

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240712000524 NY Practitioner - Physical Therapist in Private Practice 0446795678 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039549-01NYMDPhysical Therapist

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1447933817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 DEKALB AVE APT 5E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671236",
            "telephone_number": "551-655-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 DEKALB AVE APT 5E",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671236",
            "telephone_number": "551-655-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "KRYSTEL MARTINEZ",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039549-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.