Kevin Breen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT023854 Issued in PA

Practice address

1265 Wayne Ave Ste 308
119 Professional Building
Indiana, PA 15701-3501

Phone

(724) 801-8095

Fax

(724) 801-8147

NPI assigned

Nov 7, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports and Back PT LLCGroup PAC ID 6800048604, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sports and Back PT LLC

  • Physical Therapy Clinic/Center
  • Langhorne, PA
  • NPI 1508115056

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415318400000",
    "number": "1952707614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE STE 308",
            "address_2": "119 PROFESSIONAL BUILDING",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-801-8095",
            "fax_number": "724-801-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 WAYNE AVE STE 308",
            "address_2": "119 PROFESSIONAL BUILDING",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013501",
            "telephone_number": "724-801-8095",
            "fax_number": "724-801-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEN",
        "first_name": "KEVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark W Boyd, CFNP
• Mark E Boykiw, M.D.
• Tess M Bradley, MS
• Tyler J Bradley
• Cindy Bratton, MT, NMT
• Stephanie Jo Bressler, CRNP
• Rebecca Susan Brindle, B.A.
• Michelle Lynn Brink
• Shayla Bawn Brink
• Vanessa Britton, PC

• Physical Therapist in Indiana, PA
• Providers in Indiana, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.