Active NPI
Tatyana Beyzerov, PT
- Physical Therapist
- Indianapolis, IN
National Provider Identifier
1124136577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05005785A
- Practice address
- 1481 W 10TH St
PMRS Routing Number 117
Indianapolis, IN 46202-2803 - Phone
- (317) 988-2368
- NPI assigned
- Aug 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05005785A | IN | Primary |
Addresses
Primary practice location
1481 W 10TH St
PMRS Routing Number 117
Indianapolis, IN 46202-2803
Mailing address
3975 W 300 S
New Palestine, IN 46163-9614
Phone (317) 861-1849
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05005785A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124136577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3975 W 300 S",
"city": "NEW PALESTINE",
"state": "IN",
"postal_code": "461639614",
"telephone_number": "317-861-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1481 W 10TH ST",
"address_2": "PMRS ROUTING NUMBER 117",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022803",
"telephone_number": "317-988-2368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEYZEROV",
"first_name": "TATYANA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05005785A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.