Individual provider Active NPI

Kathryn Enegren, DPT

  • Physical Therapist
  • Northridge, CA
National Provider Identifier
1902155658
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39080 Issued in CA
Practice address
11225 Tampa Ave
Northridge, CA 91326-1610
Phone
(818) 363-9970
Fax
(818) 363-9980
NPI assigned
Sep 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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 PT39080 CA Primary

Addresses

Primary practice location

11225 Tampa Ave
Northridge, CA 91326-1610

Mailing address

27125 Sierra Hwy
Ste 203
Canyon Country, CA 91351-5428
Phone (661) 250-9940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121128000506 CA Practitioner - Physical Therapist in Private Practice 7416109335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vargo Physical Therapy, Inc.Group PAC ID 4486639143, 30 clinicians

Practice addresses (Care Compare)

11225 Tampa Ave
Northridge, CA 91326-1610
Phone (818) 363-9970

Merit-based Incentive Payment System (MIPS)

Final score
61.07 of 100Reported as group
Quality
51.37
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39080CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vargo Physical Therapy, Inc. Physical Therapist CurrentSince Aug 30, 2012 Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Vargo Physical Therapy, Inc Physical Therapist Past Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

27125 Sierra Hwy
Ste 203
Canyon Country, CA 91351
Phone (661) 250-9940

4211 Tierra Rejada Rd
Moorpark, CA 93021
Phone (805) 523-8076

11225 Tampa Ave
Porter Ranch, CA 91326
Phone (818) 363-9970

25115 Avenue Stanford
#B135
Valencia, CA 91355

Organizations & group practices 4

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": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1902155658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27125 SIERRA HWY",
            "address_2": "STE 203",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913515428",
            "telephone_number": "661-250-9940",
            "fax_number": "661-250-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 TAMPA AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913261610",
            "telephone_number": "818-363-9970",
            "fax_number": "818-363-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENEGREN",
        "first_name": "KATHRYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT39080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.