Janet M Kristobak

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT003436L Issued in PA

Practice address

118 Main St
Tidioute, PA 16351-1056

Phone

(814) 484-1100

Fax

(814) 484-1102

NPI assigned

Jul 11, 2008

Last updated

Jul 16, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Janet Prentice Kristobak Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Excel Physical Therapy

  • Physical Therapist
  • Seneca, PA
  • NPI 1760773501
  NPD (past)

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1972767770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 STATE ROUTE 257 SUITE 1",
            "address_2": "PO BOX 248",
            "city": "SENECA",
            "state": "PA",
            "postal_code": "163460248",
            "telephone_number": "814-670-0534",
            "fax_number": "814-670-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN ST",
            "city": "TIDIOUTE",
            "state": "PA",
            "postal_code": "163511056",
            "telephone_number": "814-484-1100",
            "fax_number": "814-484-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTOBAK",
        "first_name": "JANET",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT003436L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13580040",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "KRISTOBAK",
            "middle_name": "PRENTICE",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rachel E Ashbaugh, MS, LPC
• Darling Apothecary LLC (Darling's Tidioute Pharmacy)
• Jennifer Lynn Grasinger, MPT
• Primary Health Network (Tidioute Health Center)
• Tidioute Area Volunteer Fire Dept Inc
• Tidioute Community Charter School

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.