Individual provider Active NPI

Kelley Kukis, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1992248645
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292429 Issued in CA
Practice address
3400 Elvas Ave
Sacramento, CA 95819-1913
Phone
(916) 457-8802
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 292429 CA Primary

Addresses

Primary practice location

3400 Elvas Ave
Sacramento, CA 95819-1913

Mailing address

317 33Rd St
Sacramento, CA 95816-3312
Phone (916) 234-3876

Other practice location 1

317 33rd St
Sacramento, CA 95816-3312
Phone (916) 234-3876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
East Sacramento Physical Therapy, Inc Physical Therapist CurrentSince Mar 14, 2017 Accepting new patients
All Bodies Physical Therapy, Inc CurrentSince Apr 28, 2024 Accepting new patients

Locations

3400 Elvas Ave
Sacramento, CA 95819
Phone (916) 457-8802

Organizations & group practices 2

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1992248645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 33RD ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163312",
            "telephone_number": "916-234-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 ELVAS AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958191913",
            "telephone_number": "916-457-8802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 33rd St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958163312",
            "country_code": "US",
            "telephone_number": "916-234-3876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUKIS",
        "first_name": "KELLEY",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.