Active NPI
Kristine L Vrooman, PT
- Physical Therapist
- Oak Bluffs, MA
National Provider Identifier
1629077169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18079
- Practice address
- 4 Mourning Dove Road
Oak Bluffs, MA 02557 - Phone
- (508) 696-7923
- NPI assigned
- Jul 18, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 18079 | MA | Primary |
Addresses
Primary practice location
4 Mourning Dove Road
Oak Bluffs, MA 02557
Mailing address
RR1 Box 475KK
Edgartown, MA 02539
Phone (508) 696-7923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432093 | Other | PA | HIGHMARK BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic and Sports Physical Therapy Services, Inc. | Physical Therapist | Past | Accepting new patients |
| Orthopedic and Sports Physical Therapy Services, Inc. | Physical Therapist | Past | Accepting new patients |
| Orthopedic and Sports Physical Therapy Services, Inc. | Physical Therapist | Past | Accepting new patients |
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.
-
dba Excel Physical Therapy
- Physical Therapist
- Philadelphia, PA
- NPI 1255381448
-
dba Excel Physical Therapy
- Physical Therapist
- Bensalem, PA
- NPI 1487604658
-
dba Excel Physical Therapy
- Physical Therapist
- Philadelphia, PA
- NPI 1588661235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329264000000",
"number": "1629077169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR1 BOX 475KK",
"city": "EDGARTOWN",
"state": "MA",
"postal_code": "02539",
"telephone_number": "508-696-7923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 MOURNING DOVE ROAD",
"city": "OAK BLUFFS",
"state": "MA",
"postal_code": "02557",
"telephone_number": "508-696-7923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VROOMAN",
"first_name": "KRISTINE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-18",
"last_updated": "2012-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "18079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUESHIELD",
"identifier": "432093",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Bluffs, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.