Jack Tomasz Hadam, DPT

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

1953 Issued in NH

Practice address

685 White Mountain Hwy
Tamworth, NH 03886-4638

Phone

(603) 323-2089

Fax

(603) 323-2097

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lakeside Physical Therapy & Fitness Center

  • Physical Therapist
  • Tamworth, NH
  • NPI 1386957843
  Medicare reassignment NPD Authorized official
• Lakeside Physical Therapy & Fitness Center

  • Physical Therapy Clinic/Center
  • Tamworth, NH
  • NPI 1396984670
  NPD Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1063594950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "CHOCORUA",
            "state": "NH",
            "postal_code": "038170396",
            "telephone_number": "603-244-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 WHITE MOUNTAIN HWY",
            "city": "TAMWORTH",
            "state": "NH",
            "postal_code": "038864638",
            "telephone_number": "603-323-2089",
            "fax_number": "603-323-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADAM",
        "first_name": "JACK",
        "middle_name": "TOMASZ",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NH",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Horse
• Jennie P Carcaud-Hennigar, DMD
• James John Cubeddu, PA-C
• E-Z Optical
• Annemarie E Green, LMT,CMT
• Mary Kathleen Hanson, OTR/L
• Huggins Hospital (Tamworth Family Medicine)
• Brian R Irwin, D.O.
• Lakeside Physical Therapy & Fitness Center
• Lakeside Physical Therapy & Fitness Center

• Legal Medicine in Tamworth, NH
• Providers in Tamworth, NH by specialty
• Legal Medicine in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.