Alyssa Kozak

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502005636 Issued in MI

Practice address

13439 E 14 Mile Rd
Sterling Heights, MI 48312-6304

Phone

(586) 685-0505

Fax

(586) 685-0501

NPI assigned

Jul 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1083190524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25775 W 10 MILE RD STE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334856",
            "telephone_number": "248-809-9941",
            "fax_number": "248-809-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13439 E 14 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483126304",
            "telephone_number": "586-685-0505",
            "fax_number": "586-685-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501000205",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samar Koujan Basha, DDS
• Kathleen Kovach
• Amanda Kowalski
• Jenna Marie Kowalski
• Nicolai Joseph Kowalski
• Brianna Kozel
• Pawel Koziol
• Karie Lynn Kozlowski, BEHAVIORAL TECH
• Kathrine Rose Kranz, PA
• Diane Valeria Krasicky, OT

• Physical Therapy Assistant in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.