Individual provider Active NPI

Kerri Yvonne Demitrovic, P.T.

  • Physical Therapist
  • Dobbs Ferry, NY
National Provider Identifier
1912097296
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0242461 Issued in NY
Practice address
62 Mohican PK Ave
Dobbs Ferry, NY 10522-2309
Phone
(914) 844-7580
Fax
(914) 478-3106
NPI assigned
Oct 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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 0242461 NY Primary

Addresses

Primary practice location

62 Mohican PK Ave
Dobbs Ferry, NY 10522-2309

Mailing address

62 Mohican PK Ave
Dobbs Ferry, NY 10522-2309
Phone (914) 844-7580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070327000447 NY Practitioner - Physical Therapist in Private Practice 3375647621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

62 Mohican PK Ave
Dobbs Ferry, NY 10522-2309
Phone (914) 844-7580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2359KSMDMental Health Counselor
0242461NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocare Physical Therapy CurrentSince Sep 1, 2013 Accepting new patients
Proactive Physical Therapy & Sports Rehabilitation, PLLC CurrentSince Sep 1, 2017 Accepting new patients
KD Physical Therapy PLLC CurrentSince Mar 1, 2012 Accepting new patients

Locations

1053 Saw Mill River Rd
Ardsley, NY 10502
Phone (914) 674-0733

1053 Saw Mill River Rd
Ste 105
Ardsley, NY 10502
Phone (914) 693-2350

145 Palisade St
Ste 200
Dobbs Ferry, NY 10522
Phone (484) 680-1355

465 Columbus Ave
Valhalla, NY 10595
Phone (914) 401-8082

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": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1912097296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MOHICAN PK AVE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222309",
            "telephone_number": "914-844-7580",
            "fax_number": "914-478-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MOHICAN PK AVE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222309",
            "telephone_number": "914-844-7580",
            "fax_number": "914-478-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMITROVIC",
        "first_name": "KERRI",
        "middle_name": "YVONNE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0242461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dobbs Ferry, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.