Individual provider Active NPI

Kristin Wise, P.T.

  • Physical Therapist
  • Santa Barbara, CA
National Provider Identifier
1992806962
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24580 Issued in CA
Practice address
215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone
(805) 681-1761
Fax
(805) 681-1768
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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 PT24580 CA Primary

Addresses

Primary practice location

215 Pesetas LN
Santa Barbara, CA 93110-1416

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061221000323 CA Practitioner - Physical Therapist in Private Practice 6709886708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2320 Calle Real
Santa Barbara, CA 93105-4231
Phone (805) 687-8553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT24580CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara Comprehensive Outpatient Rehabilitation Facility Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients

Locations

2320 Calle Real
Santa Barbara, CA 93105
Phone (805) 687-8553

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, 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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1992806962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PESETAS LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101416",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KRISTIN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.