Organization Active NPI

Boerne Physical Therapy Institute

  • Physical Therapy Clinic/Center
  • Boerne, TX
National Provider Identifier
1164604575
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
163071 Issued in TX
Legal business name
BOERNE PHYSICAL THERAPY INSTITUTE
Practice address
430 W Bandera Rd
#9
Boerne, TX 78006-2500
Phone
(830) 249-7211
Fax
(830) 249-4698
NPI assigned
Nov 28, 2007
Last updated
Nov 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Mr. Daniel Ernest Kasprowicz Jr., P.T., A.T.C.NPI 1972641272
Title
Owner/Physical Therapist
Phone
(830) 249-7211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 163071 TX Primary

Addresses

Primary practice location

430 W Bandera Rd
#9
Boerne, TX 78006-2500

Mailing address

430 W Bandera Rd
#9
Boerne, TX 78006-2500
Phone (830) 249-7211

Other identifiers 1

IdentifierTypeStateIssuer
83073TOtherTXBLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090717000490 TX Part B Supplier - Clinic/Group Practice 2264584598 Receives reassigned benefits from 3 practitioners
Practice locations: Boerne, TX

National Provider Directory

National Provider Directory

Locations

1411 S Main St
Ste 102
Boerne, TX 78006
Phone (830) 249-7211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1164604575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W BANDERA RD",
            "address_2": "#9",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062500",
            "telephone_number": "830-249-7211",
            "fax_number": "830-249-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W BANDERA RD",
            "address_2": "#9",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062500",
            "telephone_number": "830-249-7211",
            "fax_number": "830-249-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOERNE PHYSICAL THERAPY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "KASPROWICZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "830-249-7211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.T.,  A.T.C."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "163071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "83073T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.