Individual provider Active NPI

Lerato Nkemetse Kitleli, MPT

  • Physical Therapist
  • Manassas, VA
National Provider Identifier
1487804290
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205809 Issued in VA
Practice address
8644 Sudley Rd Ste 308
Manassas, VA 20110-4425
Phone
(571) 292-9910
NPI assigned
Sep 29, 2008
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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 19799 MD
Physical Therapist 225100000X 2305205809 VA Primary

Addresses

Primary practice location

8644 Sudley Rd Ste 308
Manassas, VA 20110-4425

Mailing address

8644 Sudley Rd Ste 308
Manassas, VA 20110-4425
Phone (571) 292-9910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100128000682 DC Practitioner - Physical Therapist in Private Practice 4880736826 Reassigns benefits to 3 organizations
I20160111000003 VA Practitioner - Physical Therapist in Private Practice 4880736826 Reassigns benefits to 4 organizations

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
Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

115 Park St SE
Suite 300
Vienna, VA 22180-4653
Phone (703) 255-9100

1808 Plaza Dirve
Winchester, VA 22601
Phone (540) 665-2750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19799MDMDPhysical Therapist
2305205809VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of VA, LLC Physical Therapist Current Accepting new patients
Drayer PT of VA LLC Physical Therapist CurrentSince Sep 11, 2022 Accepting new patients
Inova Physician Partners, LLC CurrentSince Jun 25, 2020 Accepting new patients
Drayer Physical Therapy Virginia, LLC Physical Therapist CurrentSince Sep 11, 2022 Accepting new patients
Drayer PT of VA LLC Physical Therapist CurrentSince Sep 11, 2022 Accepting new patients
Benchmark Physical Therapy of VA, LLC Physical Therapist CurrentSince Sep 11, 2022 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

26106 Lee Hwy
Abingdon, VA 24211
Phone (276) 623-0274

6201 Centreville Rd
Ste 100
Centreville, VA 20121
Phone (703) 263-9600

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

800 Shenandoah Ave
Ste 140
Elkton, VA 22827
Phone (540) 298-4749

313 Neff Ave
Ste C
Harrisonburg, VA 22801
Phone (540) 434-1200

4011B Wards Rd
Lynchburg, VA 24502
Phone (434) 284-7894

740 E Main St
Purcellville, VA 20132
Phone (540) 338-4995

4165 Quarles Ct
#1
Rockingham, VA 22801
Phone (540) 437-7585

100 Founders Way
Ste 1
Strasburg, VA 22657
Phone (540) 465-2505

115 Park St SE
Ste 300
Vienna, VA 22180
Phone (703) 255-9100

1808 Plaza Dr
Winchester, VA 22601
Phone (540) 665-2750

2076 Daniel Stuart Sq
Woodbridge, VA 22191
Phone (703) 462-1231

Organizations & group practices 9

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1487804290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8644 SUDLEY RD STE 308",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104425",
            "telephone_number": "571-292-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8644 SUDLEY RD STE 308",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104425",
            "telephone_number": "571-292-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITLELI",
        "first_name": "LERATO",
        "middle_name": "NKEMETSE",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19799",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.