Individual provider Active NPI

Edward W Kalten Jr., PT

  • Physical Therapist
  • Bay Shore, NY
National Provider Identifier
1932125689
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021499 Issued in NY
Practice address
53 Brentwood Rd
Suite B
Bay Shore, NY 11706-6923
Phone
(631) 328-5920
Fax
(631) 328-5921
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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 021499 NY Primary

Addresses

Primary practice location

53 Brentwood Rd
Suite B
Bay Shore, NY 11706-6923

Mailing address

206 N Iowa Ave
N Massapequa, NY 11758-1323
Phone (516) 293-8224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000453 NY Practitioner - Physical Therapist in Private Practice 8820073372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

53 Brentwood Rd
Suite B
Bay Shore, NY 11706-6943
Phone (631) 328-5920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021499NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health PT & Pta, PLLC Physical Therapist CurrentSince Oct 1, 2008 Accepting new patients

Locations

53 Brentwood Rd
Ste B
Bay Shore, NY 11706
Phone (631) 328-5920

Organizations & group practices 1

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1932125689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N IOWA AVE",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581323",
            "telephone_number": "516-293-8224",
            "fax_number": "631-328-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BRENTWOOD RD",
            "address_2": "SUITE B",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066923",
            "telephone_number": "631-328-5920",
            "fax_number": "631-328-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALTEN",
        "first_name": "EDWARD",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.