Kierstin Mireku

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305215313 Issued in VA

Practice address

10521 Rosehaven St
# 150 LL
Fairfax, VA 22030

Phone

(703) 383-1616

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Art Bronsord and Associates Physical Therapy L.L.C.Group PAC ID 9931271848, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Art Bronsord & Associates Physical Therapy L.L.C.

  dba State of The Art Physical Therapy

  • Physical Therapist
  • Ashburn, VA
  • NPI 1801068069
  Medicare reassignment Care Compare group NPD
• Excel Rehabilitation, PLLC

  • Specialist
  • Fairfax, VA
  • NPI 1922091032

  DC

  Medicare reassignment NPD
• Jackson Clinics Limited Partnership

  • Physical Therapist
  • Centreville, VA
  • NPI 1639594831

  DC

  Medicare reassignment NPD
• Virginia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Fairfax, VA
  • NPI 1235720848

  DC

  Medicare reassignment NPD
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1720706583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST",
            "address_2": "# 150 LL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302889",
            "telephone_number": "703-383-1616",
            "fax_number": "703-383-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 ROSEHAVEN ST",
            "address_2": "# 150 LL",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-383-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Elden St Ste 240",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201704845",
            "country_code": "US",
            "telephone_number": "703-689-3737",
            "fax_number": "703-689-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIREKU",
        "first_name": "KIERSTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marshall C Mintz, MD
• Minuteclinic Diagnostic of Virginia LLC
• Alexandra Nicole Minutillo
• Mira Genetix
• Heather Miranda
• Ahmadshah Mirkhel, M.D.
• Kenneth R Mirkin, M.D.
• Fatima Mirza, PHD, LCSW
• Sohail K Mirza, M.D., M.P.H.
• Sulman A Mirza, M.D.

• Physical Therapist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.