Kristen Dibernardo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61687060 Issued in WA

Practice address

6842 Race Track Rd Ste B
Bowie, MD 20715-3011

Phone

(240) 544-0200

NPI assigned

May 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WA, DC, MD, ID5 enrollments

Enrollment records 5

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ati Holdings, LLC

  • Physical Therapy Clinic/Center
  • Rising Sun, MD
  • NPI 1396781050

  DC, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Apple Physical Therapy, LLC

  • Physical Therapist
  • Auburn, WA
  • NPI 1902808470
  Medicare reassignment Care Compare group NPD
• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372

  ID

  Medicare reassignment Care Compare group NPD
• Schopp Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Torrance, CA
  • NPI 1295367134
  Medicare reassignment NPD
• Apple Physical Therapy LLC

  • Durable Medical Equipment & Medical Supplies
  • Mountlake Terrace, WA
  • NPI 1366746232

  Physical Therapist

  NPD
• Ati Holdings, LLC

  • Durable Medical Equipment & Medical Supplies
  • King of Prussia, PA
  • NPI 1750194460

  Physical Therapist

  NPD
• Crossroads Rehab LLC

  • Physical Therapist
  • Kailua Kona, HI
  • NPI 1164883385
  NPD
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Atascadero, CA
  • NPI 1225046824

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1700576865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6842 RACE TRACK RD STE B",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153011",
            "telephone_number": "240-544-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 Shasta Ave",
            "address_purpose": "LOCATION",
            "city": "Morro Bay",
            "state": "CA",
            "postal_code": "934421933",
            "country_code": "US",
            "telephone_number": "805-772-4325",
            "fax_number": "805-772-2886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5605 100th St SW Ste B",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992710",
            "country_code": "US",
            "telephone_number": "253-284-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIBERNARDO",
        "first_name": "KRISTEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304040",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27531",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61687060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Developmental Group LLC
• Developmental Impact, LLC
• Samantha Marie Devizio, DC
• Jmyla Dews
• Mehichata Kamate Diarrassouba
• Precious Eunice Dibson
• Naomi Dickenson
• Darrissa Dickey
• Shana Ashley Dicks, DDS
• Digestive and Biliary Disease Consultants LLC

• Physical Therapist in Bowie, MD
• Providers in Bowie, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.