Active NPI
Philip Jason Mazzei, LAT, ATC
- Athletic Trainer
- Altoona, WI
National Provider Identifier
1144784331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2270-39
- Practice address
- 1200 Oakleaf Way # a
Altoona, WI 54720-2245 - Phone
- (800) 322-1747
- NPI assigned
- Jan 22, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2270-39 | WI | Primary |
Addresses
Primary practice location
1200 Oakleaf Way # a
Altoona, WI 54720-2245
Mailing address
1519 Glades Dr
Altoona, WI 54720-2539
Phone (715) 456-9109
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 |
|---|---|---|---|
| 2270-39 | WI | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wisconsin System Non Payroll | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- NPI 1821292343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1144784331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 GLADES DR",
"city": "ALTOONA",
"state": "WI",
"postal_code": "547202539",
"telephone_number": "715-456-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 OAKLEAF WAY # A",
"city": "ALTOONA",
"state": "WI",
"postal_code": "547202245",
"telephone_number": "800-322-1747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZEI",
"first_name": "PHILIP",
"middle_name": "JASON",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-22",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "2270-39",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altoona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.