Individual provider Active NPI

Nathaniel Creznic, PT

  • Physical Therapist
  • Harrisburg, PA
National Provider Identifier
1144464447
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018772 Issued in PA
Practice address
4300 Londonderry Rd
2ND FL, Bma
Harrisburg, PA 17109-5317
Phone
(717) 657-7520
Fax
(717) 657-7505
NPI assigned
Apr 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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 PT018772 PA Primary

Addresses

Primary practice location

4300 Londonderry Rd
2ND FL, Bma
Harrisburg, PA 17109-5317

Mailing address

118 Washington St
Harrisburg, PA 17104-1677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150203002150 PA Practitioner - Physical Therapist in Private Practice 6204003478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 4TH St
East Berlin, PA 17316-9638
Phone (717) 585-0510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PHS Physical Therapy, LLC CurrentSince Jan 1, 2015 Accepting new patients
Commonhealth Orthopedic Physical Therapy Physical Therapist CurrentSince Oct 25, 2011 Accepting new patients
PHS Physical Therapy, LLC Physical Therapist CurrentSince Jan 1, 2015 Accepting new patients

Locations

1535 Highlands Dr
Ste 200
Lititz, PA 17543
Phone (717) 625-5731

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1144464447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WASHINGTON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD",
            "address_2": "2ND FL, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-657-7520",
            "fax_number": "717-657-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREZNIC",
        "first_name": "NATHANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.