Individual provider Active NPI

Monique Krebsbach, PT

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1720028228
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
565 Issued in MT
Practice address
309 SW Higgins Ave
Missoula, MT 59803-1405
Phone
(406) 829-0728
Fax
(406) 829-0728
NPI assigned
Jun 7, 2006
Last updated
Jan 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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 565 MT Primary

Addresses

Primary practice location

309 SW Higgins Ave
Missoula, MT 59803-1405

Mailing address

309 SW Higgins Ave
Missoula, MT 59803-1405
Phone (406) 829-0728

Other identifiers 2

IdentifierTypeStateIssuer
0341802MedicaidMT
0172666MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000869 MT Practitioner - Physical Therapist in Private Practice 2264492990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

309 SW Higgins Ave
Missoula, MT 59803-1405
Phone (406) 829-0728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
565MTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monique Krebsbach PT, Inc Physical Therapist CurrentSince Feb 1, 2008 Accepting new patients
Physical Therapy on the Move PC Physical Therapist PastSince Aug 20, 2007 Accepting new patients

Locations

309 SW Higgins Ave
Missoula, MT 59803
Phone (406) 542-0177

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1720028228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SW HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031405",
            "telephone_number": "406-829-0728",
            "fax_number": "406-829-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SW HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031405",
            "telephone_number": "406-829-0728",
            "fax_number": "406-829-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREBSBACH",
        "first_name": "MONIQUE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0341802",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172666",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.