Active NPI
Thomas J Szakal, PT
- Physical Therapist
- Willoughby, OH
National Provider Identifier
1003859273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT04945
- Practice address
- 5105 Som Center Road
Willoughby, OH 44094-4273 - Phone
- (440) 953-5792
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT04945 | OH | Primary |
Addresses
Primary practice location
5105 Som Center Road
Willoughby, OH 44094-4273
Mailing address
5105 Som Center Rd
Willoughby, OH 44094-4203
Phone (440) 953-5792
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2332498 | Medicaid | OH | |
| 9304631 | Other | OH | MEDICARE GROUP ID |
| 1003859273 | Other | OH | KAISER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT04945 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Universal Therapy Dynamics, Inc | Past | Accepting new patients |
Interoperability endpoints
- tszakal39227@ehrdirect.uhhospitals.org
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Willoughby, OH
- NPI 1740288919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1003859273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 SOM CENTER RD",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440944203",
"telephone_number": "440-953-5792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5105 SOM CENTER ROAD",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440944273",
"telephone_number": "440-953-5792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SZAKAL",
"first_name": "THOMAS",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT04945",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2332498",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP ID",
"identifier": "9304631",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "1003859273",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.