Individual provider Active NPI

Anna Kitchen, PT, DPT

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1851752737
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01656000 Issued in NJ
Practice address
3830 Park Ave
Edison, NJ 08820-2562
Phone
(732) 494-0895
Fax
(732) 494-0896
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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 40QA01656000 NJ Primary

Addresses

Primary practice location

3830 Park Ave
Edison, NJ 08820-2562

Mailing address

3830 Park Ave
Edison, NJ 08820-2562

Other names 1

  • Anna Yegiazarova Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160628000289 NJ Practitioner - Physical Therapist in Private Practice 5991096646 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

Practice addresses (Care Compare)

590 Anderson Ave
Cliffside Park, NJ 07010-1721
Phone (201) 941-8667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 3, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 3, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients

Locations

590 Anderson Ave
Cliffside Pk, NJ 07010
Phone (201) 941-8667

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

281 Witherspoon St
Ste 201
Princeton, NJ 08540
Phone (609) 279-2194

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

576 Broadhollow Rd
Melville, NY 11747

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1851752737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 PARK AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 PARK AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202562",
            "telephone_number": "732-494-0895",
            "fax_number": "732-494-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHEN",
        "first_name": "ANNA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01656000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "YEGIAZAROVA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.