Individual provider Active NPI

Patryk Opechowski

  • Massage Therapist
  • San Diego, CA
National Provider Identifier
1205580628
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
57785 Issued in CA
Practice address
4784 Point Loma Ave
San Diego, CA 92107-3825
Phone
(619) 379-2697
NPI assigned
Feb 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 57785 CA Primary

Addresses

Primary practice location

4784 Point Loma Ave
San Diego, CA 92107-3825

Mailing address

4784 Point Loma Ave
San Diego, CA 92107-3825

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

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1205580628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4784 POINT LOMA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4784 POINT LOMA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073825",
            "telephone_number": "619-379-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPECHOWSKI",
        "first_name": "PATRYK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "57785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.