Individual provider Active NPI

Kimberly Russo Cash, PT

  • Physical Therapist
  • Winthrop, MA
National Provider Identifier
1992827695
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16429 Issued in MA
Practice address
120 Banks St
Winthrop, MA 02152-1931
Phone
(617) 846-5609
Fax
(617) 539-0025
NPI assigned
Apr 4, 2007
Last updated
Dec 12, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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 16429 MA Primary

Addresses

Primary practice location

120 Banks St
Winthrop, MA 02152-1931

Mailing address

120 Banks St
Winthrop, MA 02152-1931
Phone (617) 846-5609

Other identifiers 1

IdentifierTypeStateIssuer
Y68361OtherMABLUECROSSBLUESHIELD

Other names 1

  • Kimberly M. Russo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000723 MA Practitioner - Physical Therapist in Private Practice 8325937535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

57 Putnam St
Winthrop, MA 02152-2902

57 Putnam St
Winthrop, MA 02152-2987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16429MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Championship Physical Therapy LLC Physical Therapist CurrentSince Mar 24, 2010 Accepting new patients
Massachusetts Luna Care Physical Therapy LLC Physical Therapist CurrentSince Oct 5, 2022 Accepting new patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients

Locations

10 Post Office Sq
Ste 800
Boston, MA 02109
Phone (617) 231-0011

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

120 Banks St
Winthrop, MA 02152
Phone (617) 846-5609

57 Putnam St
Winthrop, MA 02152
Phone (617) 846-4553

Organizations & group practices 3

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1992827695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BANKS ST",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021521931",
            "telephone_number": "617-846-5609",
            "fax_number": "617-539-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BANKS ST",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "021521931",
            "telephone_number": "617-846-5609",
            "fax_number": "617-539-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASH",
        "first_name": "KIMBERLY",
        "middle_name": "RUSSO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "Y68361",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "RUSSO",
            "middle_name": "M.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winthrop, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.