Individual provider Active NPI

Anna Krzysiak, PT

  • Specialist
  • Palmdale, CA
National Provider Identifier
1720272370
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT 20960 Issued in CA
Practice address
3167 Rancho Vista Blvd Ste D
Palmdale, CA 93551-5517
Phone
(661) 266-9578
Fax
(661) 266-2270
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT 20960 CA Primary

Addresses

Primary practice location

3167 Rancho Vista Blvd Ste D
Palmdale, CA 93551-5517

Mailing address

3167 Rancho Vista Blvd Ste D
Palmdale, CA 93551-5517
Phone (661) 266-9578

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 20960CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Physical Therapy, Inc. PastSince Sep 1, 2018 Accepting new patients
Bartz-Altadonna Community Health Center 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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1720272370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3167 RANCHO VISTA BLVD STE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515517",
            "telephone_number": "661-266-9578",
            "fax_number": "661-266-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3167 RANCHO VISTA BLVD STE D",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515517",
            "telephone_number": "661-266-9578",
            "fax_number": "661-266-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZYSIAK",
        "first_name": "ANNA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 20960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.