Individual provider Active NPI

Kelly Bettez Desimone, PT

  • Physical Therapist
  • East Providence, RI
National Provider Identifier
1518907930
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
01024 Issued in RI
Practice address
1 Kettle Point Ave
East Providence, RI 02914-5375
Phone
(401) 277-0790
Fax
(401) 626-3851
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 001024 RI
Physical Therapist 225100000X 01024 RI Primary

Addresses

Primary practice location

1 Kettle Point Ave
East Providence, RI 02914-5375

Mailing address

2 Dudley St
Providence, RI 02905-3236
Phone (401) 330-1428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040216001267 RI Practitioner - Physical Therapist in Private Practice 6103711478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.76
Promoting interoperability
96
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001024RIMDSpecialist
01024RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics, Inc. CurrentSince Jul 1, 2004 Accepting new patients
University Orthopedics, Inc. CurrentSince Jul 1, 2004 Accepting new patients

Locations

1 Kettle Point Ave
East Providence, RI 02914
Phone (401) 330-1400

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

2 Dudley St
Providence, RI 02905
Phone (401) 444-2299

Interoperability endpoints

  • Direct secure messaging: kelly.desimone.1@13709.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1518907930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-330-1428",
            "fax_number": "401-626-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KETTLE POINT AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145375",
            "telephone_number": "401-277-0790",
            "fax_number": "401-626-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIMONE",
        "first_name": "KELLY",
        "middle_name": "BETTEZ",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "RI",
            "license": "001024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "01024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.