Stephen Brasko III
Individual provider Active NPI Physical Therapist · Canfield, OH
NPI 1053868596 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1053868596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT016520 (OH)
- Practice address
- 567 E Main St
Canfield, OH 44406-1547 - Phone
- (330) 533-1080
- NPI assigned
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri-County Physical Therapy Institute LLC
Practice addresses (Care Compare)
567 E Main St
Canfield, OH 44406-1547
Phone (330) 533-1080
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171213002644 | OH | Practitioner - Physical Therapist in Private Practice | 9638437007 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016520 | OH | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016520 | OH | Yes |
Addresses
Primary practice location
567 E Main St
Canfield, OH 44406-1547
Mailing address
6283 McClintocksburg Rd
Newton Falls, OH 44444-9247
Other providers in Canfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 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.