Individual provider Active NPI

Katelyn Patricia Taft, PT, DPT

  • Physical Therapist
  • Scarborough, ME
National Provider Identifier
1609322858
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5978 Issued in ME
Practice address
55 Spring St Ste B
Scarborough, ME 04074-8926
Phone
(207) 396-5165
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 5978 ME Primary

Addresses

Primary practice location

55 Spring St Ste B
Scarborough, ME 04074-8926

Mailing address

55 Spring St Ste B
Scarborough, ME 04074-8926
Phone (207) 396-5165

Other practice location 1

4 Water Street
Boston, MA 02109
Phone (617) 536-1161 ext. 3

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161011001216 MA Practitioner - Physical Therapist in Private Practice 9739477514 Reassigns benefits to 1 organization
I20210826001994 ME Practitioner - Physical Therapist in Private Practice 9739477514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5978MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Physical Therapy, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Aug 22, 2016 Accepting new patients

Locations

4 Water St
Boston, MA 02109
Phone 61753611613

654 Beacon St
Ste 2
Boston, MA 02215
Phone 61753611611

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1609322858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SPRING ST STE B",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040748926",
            "telephone_number": "207-396-5165",
            "fax_number": "207-396-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SPRING ST STE B",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040748926",
            "telephone_number": "207-396-5165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Water Street",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02109",
            "country_code": "US",
            "telephone_number": "617-536-1161 x3",
            "fax_number": "844-912-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAFT",
        "first_name": "KATELYN",
        "middle_name": "PATRICIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "5978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.