Individual provider Active NPI

Kristine Ann Skinner

  • Physical Therapist
  • Valley Cottage, NY
National Provider Identifier
1457430530
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
020314-1 Issued in NY
Practice address
704 Executive Blvd Ste H
Valley Cottage, NY 10989-2023
Phone
(845) 268-7800
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA0923300 NJ
Physical Therapist 225100000X 020314-1 NY Primary

Addresses

Primary practice location

704 Executive Blvd Ste H
Valley Cottage, NY 10989-2023

Mailing address

900 Route 9 N FL 4
Woodbridge, NJ 07095-1025

Other practice location 1

47 S Washington Ave
Bergenfield, NJ 07621-2324
Phone (201) 384-2525

Other names 1

  • Kristine Ann Loock Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018002789 NY Practitioner - Physical Therapist in Private Practice 0244336741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

7 -11 S Broadway
White Plains, NY 10601-3531
Phone (914) 898-3090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA0923300NJMDPhysical Therapist
020314-1NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Oct 15, 2020 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients
One on One Physical Therapy Services PLLC Physical Therapist Past Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

900 Route 9 N
Ste 410
Woodbridge, NJ 07095

900 Route 9 N
Fl 4
Woodbridge, NJ 07095

135 E Erie St
Blauvelt, NY 10913
Phone (845) 268-7800

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

976 Amsterdam Ave
New York, NY 10025
Phone (212) 222-9305

100 N Middletown Rd
Pearl River, NY 10965
Phone (845) 589-0556

47 Route 303
Tappan, NY 10983
Phone (845) 848-2506

704 Executive Blvd
Ste H
Valley Cottage, NY 10989
Phone (845) 268-7800

704 Executive Blvd
Valley Cottage, NY 10989

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1457430530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 9 N FL 4",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 EXECUTIVE BLVD STE H",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892023",
            "telephone_number": "845-268-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Bergenfield",
            "state": "NJ",
            "postal_code": "076212324",
            "country_code": "US",
            "telephone_number": "201-384-2525",
            "fax_number": "201-384-2625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "KRISTINE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA0923300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "020314-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "LOOCK",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Valley Cottage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.