Individual provider Active NPI

Joshua Daniel Sirkis, PT, DPT

  • Physical Therapist
  • Mena, AR
National Provider Identifier
1174166623
Registry record updated Nov 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4679 Issued in AR
Practice address
300 Crestwood Cir
Mena, AR 71953-5515
Phone
(479) 216-2315
Fax
(479) 413-8090
NPI assigned
Oct 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2024

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 4679 AR Primary

Addresses

Primary practice location

300 Crestwood Cir
Mena, AR 71953-5515

Mailing address

300 Crestwood Cir
Mena, AR 71953-5515
Phone (479) 216-2315

Other identifiers 1

IdentifierTypeStateIssuer
303127721MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321000392 AR Practitioner - Physical Therapist in Private Practice 4486091899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Spine and Therapy, LLCGroup PAC ID 0648629618, 2 clinicians

Practice addresses (Care Compare)

1311B Hwy 71 N
Mena, AR 71953-8447
Phone (479) 216-2315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4679ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine & Therapy, LLC Physical Therapist CurrentSince Mar 11, 2024 Accepting new patients

Locations

1311B Highway 71 N
Mena, AR 71953
Phone (479) 216-2315

300B Crestwood Cir
Mena, AR 71953
Phone (479) 394-1833

300 Crestwood Cir
Mena, AR 71953
Phone (479) 394-1600

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.

NPI Registry JSON

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1174166623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535515",
            "telephone_number": "479-216-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535515",
            "telephone_number": "479-216-2315",
            "fax_number": "479-413-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRKIS",
        "first_name": "JOSHUA",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "4679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303127721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mena, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; 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.