Ethan Lizak, PT, DPT
Individual provider Active NPI Physical Therapist · Hatfield, PA
NPI 1043046808 · NPPES record last updated Sep 10, 2024
Key facts
- NPI
- 1043046808
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT032578 (PA)
- Practice address
- 1691 Bethlehem Pike
Hatfield, PA 19440-1302 - Phone
- (267) 308-5330
- Fax
- (267) 308-5331
- NPI assigned
- Sep 10, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Core 3 Physical Therapy LLC
Practice addresses (Care Compare)
1699 Bethlehem Pike
Suite 3
Hatfield, PA 19440-1302
Phone (267) 308-5330
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241009000116 | PA | Practitioner - Physical Therapist in Private Practice | 8022549427 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Core 3 Physical Therapy, LLC | Current |
Accepting new patients |
Locations
100 Steward Ln
Chalfont, PA 18914
Phone (215) 789-6543
1691 Bethlehem Pike
Hatfield, PA 19440
Phone (267) 308-5330
1699 Bethlehem Pike
#3
Hatfield, PA 19440
Phone (267) 308-5330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT032578 | PA | Yes |
Addresses
Primary practice location
1691 Bethlehem Pike
Hatfield, PA 19440-1302
Mailing address
1691 Bethlehem Pike
Hatfield, PA 19440-1302
Phone (267) 308-5330
Other providers in Hatfield, PA
- KTM II Supermarkets LLC
- Dylan Kummery
- Labstar Diagnostics LLC
- Ciena Diane Lavallee
- Janet B Leidy
- Paul McCann
- Amber McCarthy
- Sean McElhare
- Lauren A. McGrann
- David Patrick McGuane
All providers in Hatfield, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.