Active NPI
Brian C Shak, M.S.P.T.
- Physical Therapist
- Easton, PA
National Provider Identifier
1174587885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT013574L
- Practice address
- 318 Town Center Blvd
Easton, PA 18040-8366 - Phone
- (610) 253-3300
- NPI assigned
- Apr 12, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT013574L | PA | Primary |
Addresses
Primary practice location
318 Town Center Blvd
Easton, PA 18040-8366
Mailing address
150 Chase Hollow Dr
Nazareth, PA 18064-8104
Phone (610) 746-9432
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7692221 | Other | PA | AETNA PROVIDER ID |
| P2607186 | Other | PA | OXFORD PROVIDER ID |
| P00028339 | Other | PA | RR MEDICARE PROVIDER ID |
| 01133301 | Other | PA | CAPITAL BLUE CROSS PROVID |
| 1300887 | Other | PA | BLUE SHILED PROVIDER ID |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174587885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 CHASE HOLLOW DR",
"city": "NAZARETH",
"state": "PA",
"postal_code": "180648104",
"telephone_number": "610-746-9432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 TOWN CENTER BLVD",
"city": "EASTON",
"state": "PA",
"postal_code": "180408366",
"telephone_number": "610-253-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAK",
"first_name": "BRIAN",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "M.S.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT013574L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER ID",
"identifier": "7692221",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD PROVIDER ID",
"identifier": "P2607186",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PROVIDER ID",
"identifier": "P00028339",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS PROVID",
"identifier": "01133301",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHILED PROVIDER ID",
"identifier": "1300887",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Easton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.