Individual provider Active NPI

Scott Rezac, PT, DPT, OCS, CSCS,

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1003926585
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8589 Issued in CO
Practice address
1817 N Union Blvd Ste a
Colorado Springs, CO 80909-2268
Phone
(719) 465-1502
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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 8589 CO Primary

Addresses

Primary practice location

1817 N Union Blvd Ste a
Colorado Springs, CO 80909-2268

Mailing address

6444 Morning Dove Dr
Colorado Springs, CO 80923-4441
Phone (719) 380-9978

Other identifiers 1

IdentifierTypeStateIssuer
8589OtherCOLICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090617000336 CO Practitioner - Physical Therapist in Private Practice 2567436397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rezac and Associates Physical Therapy PLLCGroup PAC ID 1850441247, 10 clinicians

Practice addresses (Care Compare)

855 Citadel Dr E
Colorado Springs, CO 80909-5304
Phone (719) 465-1502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rezac & Associates Physical Therapy, LLC Physical Therapist CurrentSince Apr 30, 2003 Accepting new patients

Locations

855 Citadel Dr E
Colorado Springs, CO 80909
Phone (719) 465-1502

1817 N Union Blvd
Ste A
Colorado Springs, CO 80909
Phone (719) 465-1502

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1003926585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 MORNING DOVE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809234441",
            "telephone_number": "719-380-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 N UNION BLVD STE A",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092268",
            "telephone_number": "719-465-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAC",
        "first_name": "SCOTT",
        "credential": "PT, DPT, OCS, CSCS,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "8589",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.