Individual provider Active NPI

Kelly Ann Houlihan

  • Physical Therapist
  • Belchertown, MA
National Provider Identifier
1497413942
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
25 Bridge St
Belchertown, MA 01007-8909
Phone
(413) 323-1020
NPI assigned
Dec 1, 2021
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 Primary

Addresses

Primary practice location

25 Bridge St
Belchertown, MA 01007-8909

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

14 Thiells Mount Ivy Rd Ste 2
Pomona, NY 10970-3038
Phone (845) 694-8808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108001538 MA Practitioner - Physical Therapist in Private Practice 8729478557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ke Ola Kino Physical Therapy, LLC Physical Therapist CurrentSince Nov 7, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 28, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 28, 2024 Accepting new patients

Locations

474 Laukapu St
Ste 2
Hilo, HI 96720
Phone (808) 339-7478

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

25 Bridge St
Belchertown, MA 01007
Phone (413) 323-1020

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1497413942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BRIDGE ST",
            "city": "BELCHERTOWN",
            "state": "MA",
            "postal_code": "010078909",
            "telephone_number": "413-323-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Thiells Mount Ivy Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "NY",
            "postal_code": "109703038",
            "country_code": "US",
            "telephone_number": "845-694-8808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOULIHAN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belchertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.