Individual provider Active NPI

Elise Louise Kraft, PT, DPT

  • Physical Therapy Assistant
  • Leesburg, VA
National Provider Identifier
1871221622
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
CP014669T Issued in VA
Practice address
210B Fort Evans Rd NE
Leesburg, VA 20176-4497
Phone
(571) 367-7960
Fax
(571) 367-0157
NPI assigned
Aug 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 2525 ND
Physical Therapy Assistant 225200000X CP014669T VA Primary

Addresses

Primary practice location

210B Fort Evans Rd NE
Leesburg, VA 20176-4497

Mailing address

210B Fort Evans Rd NE
Leesburg, VA 20176-4497
Phone (571) 367-7960

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025002963 VA Practitioner - Physical Therapist in Private Practice 7113393612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians

Practice addresses (Care Compare)

11662 Sudley Manor Dr
50B
Manassas, VA 20109-2842
Phone (571) 321-5720

21453 Epicerie PLZ
Suite 100
Sterling, VA 20164-6648
Phone (703) 662-8151

Merit-based Incentive Payment System (MIPS)

Final score
88.48 of 100Reported as group
Quality
86.04
Promoting interoperability
99
Improvement activities
40
Cost
76.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2525NDMDPhysical Therapist
CP014669TVAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist Past Accepting new patients

Locations

11662 Sudley Manor Dr
#50B
Manassas, VA 20109
Phone (571) 321-5720

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": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1871221622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210B FORT EVANS RD NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764497",
            "telephone_number": "571-367-7960",
            "fax_number": "571-367-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210B FORT EVANS RD NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764497",
            "telephone_number": "571-367-7960",
            "fax_number": "571-367-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAFT",
        "first_name": "ELISE",
        "middle_name": "LOUISE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2525",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "CP014669T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.