NPIMap

Organization Active NPI

Kinesist LLC

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1710490354
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15208 Issued in FL
Legal business name
KINESIST LLC
Practice address
12064 Sprite LN
Orlando, FL 32832-6593
Phone
(321) 303-6276
NPI assigned
Nov 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Authorized official

Name
Mr. Frank MutokaNPI 1255498101
Title
Owner
Phone
(321) 303-6276

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT15208 FL Primary

Addresses

Primary practice location

12064 Sprite LN
Orlando, FL 32832-6593

Mailing address

12064 Sprite LN
Orlando, FL 32832-6593
Phone (321) 303-6276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180205001138 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7012277452 Receives reassigned benefits from 4 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1710490354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12064 SPRITE LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326593",
            "telephone_number": "321-303-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12064 SPRITE LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326593",
            "telephone_number": "321-303-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINESIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "MUTOKA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-303-6276",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT15208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.