Individual provider Active NPI

Alyson Kristofik, PT

  • Physical Therapist
  • Port St Lucie, FL
National Provider Identifier
1467772277
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24953 Issued in FL
Practice address
1680 SE Lyngate Dr
Suite 203
Port St Lucie, FL 34952-4300
Phone
(772) 335-7966
Fax
(772) 335-7963
NPI assigned
Jun 3, 2010
Last updated
Jun 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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 PT24953 FL Primary

Addresses

Primary practice location

1680 SE Lyngate Dr
Suite 203
Port St Lucie, FL 34952-4300

Mailing address

PO Box 8600
Port St. Lucie, FL 34985
Phone (772) 335-7966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy & Sports Medicine Physical Therapist Past Accepting new patients
Premier Physical Therapy Sport Medicine Inc Physical Therapist Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1467772277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8600",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34985",
            "telephone_number": "772-335-7966",
            "fax_number": "772-335-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SE LYNGATE DR",
            "address_2": "SUITE 203",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349524300",
            "telephone_number": "772-335-7966",
            "fax_number": "772-335-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTOFIK",
        "first_name": "ALYSON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.