Individual provider Active NPI

Kalah Kaszanits

  • Physical Therapist
  • Gastonia, NC
National Provider Identifier
1790201358
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P17385 Issued in NC
Practice address
2675 Court Dr
Gastonia, NC 28054
Phone
(704) 824-7800
Fax
(704) 824-2822
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 P17385 NC Primary

Addresses

Primary practice location

2675 Court Dr
Gastonia, NC 28054

Mailing address

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

Other practice location 1

1289 Oliver St
Fayetteville, NC 28304-4450
Phone (910) 483-8331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230524002367 MD Practitioner - Physical Therapist in Private Practice 4981933405 Reassigns benefits to 2 organizations
I20230622003469 DC Practitioner - Physical Therapist in Private Practice 4981933405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breakaway Physical Therapy, LLCGroup PAC ID 8123330222, 5 clinicians

Practice addresses (Care Compare)

2138 Priest Bridge CT
Suite 7
Crofton, MD 21114-2463
Phone (410) 721-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P17385NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT MD LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince May 9, 2023 Accepting new patients
Breakaway Physical Therapy, LLC Physical Therapist CurrentSince Oct 2, 2023 Accepting new patients
Pediatric Developmental Therapy Past Accepting new patients
Pediatric Developmental Therapy Physical Therapist Past Accepting new patients

Locations

2138 Priest Bridge Ct
Ste 7
Crofton, MD 21114
Phone (301) 807-8972

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 5

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": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1790201358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541478",
            "telephone_number": "704-824-7800",
            "fax_number": "704-824-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-824-7800",
            "fax_number": "704-824-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1289 Oliver St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044450",
            "country_code": "US",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASZANITS",
        "first_name": "KALAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.