Individual provider Active NPI

Benjamin Kagen, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1730557620
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11715 Issued in AZ
Practice address
15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone
(480) 940-8299
Fax
(480) 704-0888
NPI assigned
Sep 9, 2015
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11715 AZ Primary
Sports Physical Therapist 2251S0007X NU
Orthopedic Physical Therapist 2251X0800X NU

Addresses

Primary practice location

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150928002696 AZ Practitioner - Physical Therapist in Private Practice 7911215728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

6632 E Baseline Rd
Suite 102
Mesa, AZ 85206-4428
Phone (408) 219-7519

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11715AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Oct 8, 2018 Accepting new patients
Ideal Rehabilitation LLC PastSince Oct 8, 2018 Accepting new patients

Locations (25 of 52)

11335 W Buckeye Rd
Ste C105
Avondale, AZ 85323

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

235 S Dobson Rd
Ste 3
Chandler, AZ 85224
Phone (480) 306-5832

3165 S Alma School Rd
Ste 30
Chandler, AZ 85248
Phone (480) 281-0414

960 E Warner Rd
Ste 7
Chandler, AZ 85225
Phone (480) 417-4930

115 E Williams Field Rd
Ste 103
Gilbert, AZ 85295
Phone (480) 281-0779

3131 S Market St
Ste 109
Gilbert, AZ 85295

18561 N 59th Ave
Ste 117
Glendale, AZ 85308
Phone (602) 313-4089

9494 W Northern Ave
Ste 114
Glendale, AZ 85305
Phone (623) 745-3112

380 N Estrella Pkwy
Ste A1
Goodyear, AZ 85338
Phone (480) 455-6266

20320 N John Wayne Pkwy
Ste 120
Maricopa, AZ 85139
Phone (520) 635-2260

1021 N Ellsworth Rd
Mesa, AZ 85207
Phone (480) 213-0070

1021 N Ellsworth Rd
Ste 102
Mesa, AZ 85207
Phone (480) 319-8101

1712 S Country Club Dr
Ste 101
Mesa, AZ 85210
Phone (602) 313-4337

1752 S Signal Butte Rd
Ste D108
Mesa, AZ 85209
Phone (480) 417-5281

3048 E Baseline Rd
Ste 125
Mesa, AZ 85204
Phone (480) 306-8512

4360 E Brown Rd
Ste 111
Mesa, AZ 85205
Phone (480) 248-7132

6632 E Baseline Rd
Ste 102
Mesa, AZ 85206
Phone (408) 219-7519

805 N Dobson Rd
Mesa, AZ 85201
Phone (602) 313-4000

805 N Dobson Rd
Ste 105
Mesa, AZ 85201
Phone (480) 844-3609

10355 N La Canada Dr
Ste 125
Oro Valley, AZ 85737
Phone (520) 407-5966

12162 N Rancho Vistoso Blvd
Ste 120
Oro Valley, AZ 85755
Phone (520) 229-0009

9127 W Thunderbird Rd
Ste 101
Peoria, AZ 85381
Phone (623) 322-0654

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

2005 W Happy Valley Rd
Ste 170
Phoenix, AZ 85085
Phone (623) 322-0654

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1730557620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY",
            "address_2": "SUITE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "telephone_number": "480-940-8299",
            "fax_number": "480-704-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGEN",
        "first_name": "BENJAMIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11715",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.