Individual provider Active NPI

Kira Shurtz, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1619306388
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40639
Practice address
5677 Oberlin Dr
Suite 106
San Diego, CA 92121-1740
Phone
(858) 457-8419
Fax
(858) 457-0670
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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 PT40639 Primary

Addresses

Primary practice location

5677 Oberlin Dr
Suite 106
San Diego, CA 92121-1740

Mailing address

5677 Oberlin Dr
Suite 106
San Diego, CA 92121-1740
Phone (858) 457-8419

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171221001235 OR Practitioner - Physical Therapist in Private Practice 3375776354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelvic Wellness Center of SalemGroup PAC ID 9133461718, 7 clinicians

Practice addresses (Care Compare)

1655 Capitol St NE
Salem, OR 97301-7845
Phone (503) 983-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pelvic Wellness Center of Salem Physical Therapist CurrentSince May 29, 2019 Accepting new patients
Angela Yvonne Acupuncture Inc Past Accepting new patients

Locations

1655 Capitol St NE
Salem, OR 97301
Phone (503) 877-2815

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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1619306388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5677 OBERLIN DR",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211740",
            "telephone_number": "858-457-8419",
            "fax_number": "858-457-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5677 OBERLIN DR",
            "address_2": "SUITE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211740",
            "telephone_number": "858-457-8419",
            "fax_number": "858-457-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURTZ",
        "first_name": "KIRA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "PT40639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.