Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly M. Bangsted

Individual provider Physical Therapist · NPI 1295939668

Kelly M. Bangsted is a Physical Therapist in Private Practice in Brooklyn, New York. Qualified in 2006, 20 years ago. Practices with Form Physical Therapy LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
20
Licensed in
CT
In the registry since
2007
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Practice location Address checks out

15 Lawton St #21
Brooklyn, NY 11221-2523
Phone: (586) 292-0945
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 008097 (CT)

Record details

NPI number1295939668
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 12, 2007
Last updated in NPPESAugust 22, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Form Physical Therapy Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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