Individual provider Active NPI

Kaitlin Jensen, DPT

  • Physical Therapist
  • Valley Springs, CA
National Provider Identifier
1730888405
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303761 Issued in CA
Practice address
1906 Vista del Lago Dr Ste a
Valley Springs, CA 95252-9700
Phone
(209) 780-3985
Fax
(209) 222-6182
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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 303761 CA Primary

Addresses

Primary practice location

1906 Vista del Lago Dr Ste a
Valley Springs, CA 95252-9700

Mailing address

2680 Heney LN
Valley Springs, CA 95252-9516
Phone (909) 273-5462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925002083 CA Practitioner - Physical Therapist in Private Practice 4082068069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

1906 Vista del Lago Dr
Suite a
Valley Springs, CA 95252-9700
Phone (209) 772-0848

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Country Therapies, Inc CurrentSince Jun 4, 2023 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Jul 11, 2023 Accepting new patients
Cotati Rohnert Park Physical Therapy Physical Therapist PastSince Mar 1, 2023 Accepting new patients

Locations

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

Organizations & group practices 3

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": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1730888405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 HENEY LN",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952529516",
            "telephone_number": "909-273-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 VISTA DEL LAGO DR STE A",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952529700",
            "telephone_number": "209-780-3985",
            "fax_number": "209-222-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "KAITLIN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.