Individual provider Active NPI

Thomas J Szakal, PT

  • Physical Therapist
  • Willoughby, OH
National Provider Identifier
1003859273
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04945 Issued in OH
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

Updated by the provider on Aug 4, 2011

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 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

IdentifierTypeStateIssuer
2332498MedicaidOH
9304631OtherOHMEDICARE GROUP ID
1003859273OtherOHKAISER

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

LicenseStateTypeSpecialty
PT04945OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Therapy Dynamics, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.