Individual provider Active NPI

Kelcey Aguirre Hidalgo, PT

  • Physical Therapist
  • Gardnerville, NV
National Provider Identifier
1942846407
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4585 Issued in NV
Practice address
1565 Virginia Ranch Rd
Gardnerville, NV 89410-5704
Phone
(775) 782-3100
Fax
(253) 631-3899
NPI assigned
Nov 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 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 PT60645613 WA
Physical Therapist 225100000X 4585 NV Primary

Addresses

Primary practice location

1565 Virginia Ranch Rd
Gardnerville, NV 89410-5704

Mailing address

1565 Virginia Ranch Rd
Gardnerville, NV 89410-5704
Phone (877) 295-3747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006002137 NV Practitioner - Physical Therapist in Private Practice 8325446289 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60645613WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Luna Care Physical Therapy LLC Physical Therapist CurrentSince Oct 24, 2022 Accepting new patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Jun 29, 2021 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Jun 29, 2021 Accepting new patients
Puget Sound Health and Rehab LLC Physical Therapist PastSince Nov 1, 2019 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist PastSince Nov 1, 2019 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

2620 Robindale Rd
Henderson, NV 89074
Phone (702) 992-0000

5940 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 203-1964

5255 Kietzke Ln
Reno, NV 89511

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1942846407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 VIRGINIA RANCH RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105704",
            "telephone_number": "877-295-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 VIRGINIA RANCH RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105704",
            "telephone_number": "775-782-3100",
            "fax_number": "253-631-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIDALGO",
        "first_name": "KELCEY",
        "middle_name": "AGUIRRE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-20",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60645613",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardnerville, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.