Individual provider Active NPI

Krystal Kalesha Hosein, PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1669751756
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA22107 Issued in FL
Practice address
1601 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 243-6961
Fax
(305) 243-3155
NPI assigned
Aug 8, 2011
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA22107 FL Primary

Addresses

Primary practice location

1601 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

20721 NW 34TH CT
Miami Gardens, FL 33056-1211
Phone (305) 562-9707

Other practice location 1

16969 NW 67th Ave
Hialeah, FL 33015-4214
Phone (305) 364-4331

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA22107FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1669751756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20721 NW 34TH CT",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330561211",
            "telephone_number": "305-562-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-6961",
            "fax_number": "305-243-3155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16969 NW 67th Ave",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330154214",
            "country_code": "US",
            "telephone_number": "305-364-4331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSEIN",
        "first_name": "KRYSTAL",
        "middle_name": "KALESHA",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA22107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.