Active NPI
Kristina Marie Demarco, MSPT
- Specialist
- Wilkes Barre, PA
National Provider Identifier
1922354273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- DAPT003258
- Practice address
- 1140 Highway 315
Suite 207
Wilkes Barre, PA 18711-0911 - Phone
- (570) 970-0402
- NPI assigned
- Jul 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | DAPT003258 | PA | Primary |
| Physical Therapist | 225100000X | 40QA01442600 | NJ |
Addresses
Primary practice location
1140 Highway 315
Suite 207
Wilkes Barre, PA 18711-0911
Mailing address
1140 Highway 315
Suite 207
Wilkes Barre, PA 18711-0911
Phone (570) 970-0402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
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
Practice addresses (Care Compare)
2489 Route 6
Suite 6
Hawley, PA 18428-6144
Phone (570) 390-7900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DAPT003258 | PA | MD | Specialist |
| 40QA01442600 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elmtree Wellness Center, Inc. | Current | Accepting new patients | |
| Sports Care and Physical Rehabilitation Inc. | Physical Therapist | Past | Accepting new patients |
| Elite Spine and Sports Physical Therapy LP | Physical Therapist | Past | Accepting new patients |
Locations
2489 Route 6
Ste 6
Hawley, PA 18428
Phone (570) 218-7909
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.
-
- Physical Therapy Clinic/Center
- Hawley, PA
- NPI 1497293518
-
- Physical Therapist
- Wilkes Barre, PA
- NPI 1932810819
-
- Physical Therapist
- Little Silver, NJ
- NPI 1467577155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481760000000",
"number": "1922354273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 HIGHWAY 315",
"address_2": "SUITE 207",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110911",
"telephone_number": "570-970-0402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 HIGHWAY 315",
"address_2": "SUITE 207",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110911",
"telephone_number": "570-970-0402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARCO",
"first_name": "KRISTINA",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-24",
"last_updated": "2016-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "DAPT003258",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01442600",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.