Individual provider Active NPI

Kimberly Krakosky, DPT

  • Physical Therapist
  • Trenton, MI
National Provider Identifier
1760151823
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501020253 Issued in MI
Practice address
3420 West Rd
Trenton, MI 48183-2323
Phone
(734) 215-9569
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 5501020253 MI Primary

Addresses

Primary practice location

3420 West Rd
Trenton, MI 48183-2323

Mailing address

22844 Roxana Ave
Eastpointe, MI 48021-1984
Phone (586) 817-4034

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210921000898 MI Practitioner - Physical Therapist in Private Practice 3072910926 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RWW Outpatient Rehab Services, LLCGroup PAC ID 8729333521, 108 clinicians

Practice addresses (Care Compare)

3420 W Rd
Trenton, MI 48183-2323
Phone (734) 671-1923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501020253MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Level Eleven Saginaw Physical Therapist CurrentSince Sep 7, 2021 Accepting new patients
RWW Outpatient Rehab Services, LLC Physical Therapist CurrentSince Sep 7, 2021 Accepting new patients
Level Eleven Saginaw, LLC CurrentSince Oct 1, 2023 Accepting new patients
Level 11 Physical Therapy Physical Therapist CurrentSince Sep 7, 2021 Accepting new patients
Level Eleven Howell, LLC CurrentSince Sep 24, 2023 Accepting new patients
RWW Outpatient Rehab Services, LLC Physical Therapist CurrentSince Sep 7, 2021 Accepting new patients
Level Eleven Howell Physical Therapist CurrentSince Sep 7, 2021 Accepting new patients
RWW Outpatient Rehab Services, LLC Physical Therapist Current Accepting new patients

Locations

10483 Dixie Hwy
Holly, MI 48442
Phone (810) 498-2301

1030 W Highland Rd
Howell, MI 48843
Phone (517) 546-9000

5815 Bay Rd
Ste 400
Saginaw, MI 48604
Phone (989) 447-2538

13331 15 Mile Rd
Sterling Heights, MI 48312
Phone (586) 788-0702

3420 West Rd
Trenton, MI 48183
Phone (734) 215-9569

3420 West Rd
#11
Trenton, MI 48183
Phone (734) 671-1923

Organizations & group practices 8

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1760151823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22844 ROXANA AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211984",
            "telephone_number": "586-817-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 WEST RD",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832323",
            "telephone_number": "734-215-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAKOSKY",
        "first_name": "KIMBERLY",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501020253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.