Kristen Nicole Alcantara, PTA

Individual provider Active NPI Physical Therapy Assistant · Goshen, IN

NPI 1487327458 · NPPES record last updated Jul 27, 2021

Key facts

NPI
1487327458
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
06004819A (IN)
Practice address
223 Chicago Ave
Goshen, IN 46526-2311
Phone
(574) 584-3200
Fax
(574) 584-3204
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
06004819AINMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Past
since Aug 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06004819A IN Yes

Addresses

Primary practice location

223 Chicago Ave
Goshen, IN 46526-2311

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Other names

  • Kristen Nicole Werntz Former name

Other providers in Goshen, IN

All providers in Goshen, IN · Physical Therapy Assistant in Indiana

Sources for this page

Verify at the official NPI Registry.