Individual provider Active NPI

Kaitlyn J. Quigley, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1457669269
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301405 Issued in CA
Practice address
11515 El Camino Real Ste 130
San Diego, CA 92130-3034
Phone
(858) 793-1460
NPI assigned
Sep 15, 2010
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 PT02316 RI
Physical Therapist 225100000X 301405 CA Primary

Addresses

Primary practice location

11515 El Camino Real Ste 130
San Diego, CA 92130-3034

Mailing address

14 Nakomis Dr
Warwick, RI 02888-5506
Phone (401) 737-4581

Other identifiers 1

IdentifierTypeStateIssuer
PT02316OtherRISTATE LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317002798 MA Practitioner - Physical Therapist in Private Practice 1658566260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

133 Highland Ave
Salem, MA 01970-2774
Phone (978) 741-0666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc CurrentSince Mar 9, 2026 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Mar 9, 2026 Accepting new patients

Locations

133 Highland Ave
Salem, MA 01970
Phone (978) 741-0666

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": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1457669269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 NAKOMIS DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028885506",
            "telephone_number": "401-737-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 EL CAMINO REAL STE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303034",
            "telephone_number": "858-793-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGLEY",
        "first_name": "KAITLYN",
        "middle_name": "J.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02316",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PT02316",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.