Individual provider Active NPI

Timmy Maik

  • Physical Therapy Assistant
  • Philadelphia, PA
National Provider Identifier
1043687502
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI000290 Issued in PA
Practice address
933 Spring St
Philadelphia, PA 19107-1815
Phone
(215) 574-9388
Fax
(215) 574-9188
NPI assigned
Aug 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TEI000290 PA Primary

Addresses

Primary practice location

933 Spring St
Philadelphia, PA 19107-1815

Mailing address

933 Spring St
Philadelphia, PA 19107-1815
Phone (215) 574-9388

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TEI000290PAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aquatic Therapy of Chinatown Past Accepting new patients
Aquatic Therapy of Chinatown Past Accepting new patients

Organizations & group practices 2

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": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1043687502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 SPRING ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071815",
            "telephone_number": "215-574-9388",
            "fax_number": "215-574-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 SPRING ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071815",
            "telephone_number": "215-574-9388",
            "fax_number": "215-574-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIK",
        "first_name": "TIMMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI000290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.