NPIMap

Individual provider Active NPI

Kristle Marie Morahan, P.T.

  • Physical Therapist
  • Patchogue, NY
National Provider Identifier
1689961138
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030306 Issued in NY
Practice address
77 Route 112 Ste F
Patchogue, NY 11772-1230
Phone
(631) 207-2370
Fax
(631) 758-1748
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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 030306 NY Primary

Addresses

Primary practice location

77 Route 112 Ste F
Patchogue, NY 11772-1230

Mailing address

23 Wenmore LN
Port Jefferson Station, NY 11776-2831
Phone (631) 473-0426

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Charles Hospital Corp Past Accepting new patients
St Charles Rehabilitation Past Accepting new patients

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1689961138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WENMORE LN",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762831",
            "telephone_number": "631-473-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROUTE 112 STE F",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721230",
            "telephone_number": "631-207-2370",
            "fax_number": "631-758-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAHAN",
        "first_name": "KRISTLE",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.

Verify at the official NPI Registry.