Individual provider Active NPI

Krista Jo Obert-Thorn, PT

  • Physical Therapist
  • Ronkonkoma, NY
National Provider Identifier
1861090599
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011312 Issued in NY
Practice address
315 Shelter Rd
Ronkonkoma, NY 11779-4911
Phone
(631) 848-1801
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 011312 NY Primary

Addresses

Primary practice location

315 Shelter Rd
Ronkonkoma, NY 11779-4911

Mailing address

315 Shelter Rd
Ronkonkoma, NY 11779-4911
Phone (631) 478-8509

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209000800 NY Practitioner - Physical Therapist in Private Practice 4385034115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, shared by 41 NPIs, 5,925 clinicians

Practice addresses (Care Compare)

4080 Hempstead Tpke
Bethpage, NY 11714-5604
Phone (516) 745-8070

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Nov 15, 2022 Accepting new patients
Lake Shore Physical Therapy, P.C. Physical Therapist PastSince Oct 13, 2021 Accepting new patients

Locations

4080 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 738-4844

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

1312 Middle Country Rd
Selden, NY 11784
Phone (631) 698-6556

Organizations & group practices 2

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1861090599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 SHELTER RD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794911",
            "telephone_number": "631-478-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 SHELTER RD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117794911",
            "telephone_number": "631-848-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERT-THORN",
        "first_name": "KRISTA JO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "011312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.