Individual provider Active NPI

Mark Kincaid, DPT

  • Physical Therapist
  • Fort Collins, CO
National Provider Identifier
1760017388
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0016848 Issued in CO
Practice address
2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone
(970) 419-7139
Fax
(970) 493-1794
NPI assigned
Mar 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0016848 CO
Physical Therapist 225100000X PTL.0016848 CO Primary

Addresses

Primary practice location

2500 E Prospect Rd
Fort Collins, CO 80525-9718

Mailing address

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 419-7139

Other practice location 1

2015 Clubhouse Dr Ste 102
Greeley, CO 80634-3651
Phone (970) 506-4066

Other identifiers 1

IdentifierTypeStateIssuer
PTL.0016848OtherCOPHYSICAL THERAPY LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL m.kincaid@proactivephysicaltherapy.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515001064 CO Practitioner - Physical Therapist in Private Practice 1759712375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112

Merit-based Incentive Payment System (MIPS)

Final score
74.72 of 100Reported as group
Quality
70.39
Promoting interoperability
71
Improvement activities
40
Cost
69.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0016848COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Mar 16, 2020 Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Denver Physical Therapy, P.C. Physical Therapist CurrentSince Mar 16, 2020 Accepting new patients
Orthopaedic & Spine Center of the Rockies PC Physical Therapist CurrentSince Oct 9, 2020 Accepting new patients

Locations

2500 E Prospect Rd
Fort Collins, CO 80525
Phone (800) 722-7441

1926 61st Ave
Greeley, CO 80634
Phone (970) 573-3224

2015 Clubhouse Dr
Ste 102
Greeley, CO 80634
Phone (970) 506-4066

3470 E 15th St
Loveland, CO 80538
Phone (970) 663-3975

Organizations & group practices 4

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": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1760017388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-419-7139",
            "fax_number": "970-493-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259718",
            "telephone_number": "970-419-7139",
            "fax_number": "970-493-1794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Clubhouse Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806343651",
            "country_code": "US",
            "telephone_number": "970-506-4066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0016848",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PTL.0016848",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "m.kincaid@proactivephysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "I am not yet working at my clinic and do not know the exact endpoint.",
            "address_1": "2015 Clubhouse Dr Ste 102",
            "city": "Greeley",
            "state": "CO",
            "country_code": "US",
            "postal_code": "806343651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.