Individual provider Active NPI

Dustyna Roman, DPT

  • Physical Therapist
  • Hutchinson, KS
National Provider Identifier
1558826941
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-06027 Issued in KS
Practice address
2803 N Lorraine St Ste F
Hutchinson, KS 67502-4355
Phone
(620) 662-3111
NPI assigned
Feb 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 11-06027 KS Primary

Addresses

Primary practice location

2803 N Lorraine St Ste F
Hutchinson, KS 67502-4355

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (316) 263-0003

Other practice location 1

810 E 30th Ave
Hutchinson, KS 67502-4398
Phone (785) 202-1590

Other practice location 2

700 Monterey Pl
Hutchinson, KS 67502-2266
Phone (620) 663-9175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007002610 KS Practitioner - Physical Therapist in Private Practice 8921339896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced PT LLCGroup PAC ID 3678524709, 84 clinicians

Practice addresses (Care Compare)

2803 N Lorraine St
Suite F
Hutchinson, KS 67502-4355
Phone (620) 662-3111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-06027KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced PT LLC Physical Therapist CurrentSince Sep 5, 2023 Accepting new patients
Advanced PT, LLC PastSince Aug 19, 2019 Accepting new patients

Locations

2803 N Lorraine St
Ste F
Hutchinson, KS 67502
Phone (620) 662-3111

200 W Douglas Ave
Ste 1040
Wichita, KS 67202
Phone (866) 412-5554

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1558826941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "316-263-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 N LORRAINE ST STE F",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675024355",
            "telephone_number": "620-662-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 E 30th Ave",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "KS",
            "postal_code": "675024398",
            "country_code": "US",
            "telephone_number": "785-202-1590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Monterey Pl",
            "address_purpose": "LOCATION",
            "city": "Hutchinson",
            "state": "KS",
            "postal_code": "675022266",
            "country_code": "US",
            "telephone_number": "620-663-9175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "DUSTYNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-10",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutchinson, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.