Individual provider Active NPI

Jacob Stucky

  • Physical Therapist
  • Hutchinson, KS
National Provider Identifier
1053766022
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2101 N Waldron St
Hutchinson, KS 67502-1131
Phone
(620) 669-2500
Fax
(620) 694-4000
NPI assigned
Apr 27, 2016
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 NU Primary

Addresses

Primary practice location

2101 N Waldron St
Hutchinson, KS 67502-1131

Mailing address

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jacobstucky@hcpa.allscriptsdirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817003197 KS Practitioner - Physical Therapist in Private Practice 1759676547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hutchinson Clinic PA IncGroup PAC ID 5597658492, 130 clinicians

Practice addresses (Care Compare)

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Clinic, P.a., Inc. CurrentSince Jun 14, 2016 Accepting new patients
Heartland Radiation Oncology Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, PA, Inc. CurrentSince Jun 14, 2016 Accepting new patients
Hutchinson Clinic, P.a. Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients

Locations

2101 N Waldron St
Hutchinson, KS 67502
Phone (620) 669-2500

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1053766022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021131",
            "telephone_number": "620-669-2500",
            "fax_number": "620-694-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WALDRON ST",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021131",
            "telephone_number": "620-669-2500",
            "fax_number": "620-694-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKY",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacobstucky@hcpa.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Hutchinson Clinic, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2101 N Waldron St",
            "city": "Hutchinson",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675021131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hutchinson, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.