Active NPI
Martin R Dolphino, RPT
- Sports Physical Therapist
- Kansas City, KS
National Provider Identifier
1659474997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 11-03276
- Practice address
- 3901 Rainbow Blvd
Orthopedic Surgery, Ms 3017
Kansas City, KS 66160 - Phone
- (913) 588-6100
- Fax
- (913) 588-8186
- NPI assigned
- Sep 5, 2006
- Last updated
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 11-03276 | KS | |
| Sports Physical Therapist | 2251S0007X | 11-03276 | KS | Primary |
Addresses
Primary practice location
3901 Rainbow Blvd
Orthopedic Surgery, Ms 3017
Kansas City, KS 66160
Mailing address
3901 Rainbow Blvd
4070 Delp, Ms 4017
Kansas City, KS 66160
Phone (913) 588-6100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100644020A | Medicaid | KS | |
| 489114801 | Medicaid | MO | |
| 300103063 | Other | RAILROAD MEDICARE | |
| 31813022 | Other | MO | BCBS KC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-03276 | KS | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas University Physicians Inc | Past | Accepting new patients |
Organizations & group practices 1
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 KU Internal Medicine
- Internal Medicine Physician
- Kansas City, KS
- NPI 1699811521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1659474997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD",
"address_2": "4070 DELP, MS 4017",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "66160",
"telephone_number": "913-588-6100",
"fax_number": "913-588-8186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD",
"address_2": "ORTHOPEDIC SURGERY, MS 3017",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "66160",
"telephone_number": "913-588-6100",
"fax_number": "913-588-8186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLPHINO",
"first_name": "MARTIN",
"middle_name": "R",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "KS",
"license": "11-03276",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "KS",
"license": "11-03276",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100644020A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "489114801",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300103063",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS KC",
"identifier": "31813022",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.