Active NPI
Mariusz Stawowski, PT
- Orthopedic Physical Therapist
- Richland, WA
National Provider Identifier
1225005556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT00008664
- Practice address
- 702 Jadwin Ave Ste a
Richland, WA 99352-4256 - Phone
- (509) 946-9007
- Fax
- (509) 946-9755
- NPI assigned
- Mar 6, 2006
- Last updated
- Nov 5, 2007
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT00008664 | WA | Primary |
Addresses
Primary practice location
702 Jadwin Ave Ste a
Richland, WA 99352-4256
Mailing address
702 Jadwin Ave Ste a
Richland, WA 99352-4256
Phone (509) 946-9007
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7136021 | Medicaid | WA | |
| 0195507 | Other | WA | L&I |
| 7603683 | Other | WA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
702 Jadwin Ave
Suite a
Richland, WA 99352-4256
Phone (509) 946-9007
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021131 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Physical Therapy LLC | Current | Accepting new patients | |
| Sports Physical Therapy of New York, P.C. | Orthopedic | Past | Accepting new patients |
Locations
702 Jadwin Ave
Ste A
Richland, WA 99352
Phone (509) 946-9007
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Richland, WA
- NPI 1689854366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194220800000",
"number": "1225005556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 JADWIN AVE STE A",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524256",
"telephone_number": "509-946-9007",
"fax_number": "509-946-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 JADWIN AVE STE A",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524256",
"telephone_number": "509-946-9007",
"fax_number": "509-946-9755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAWOWSKI",
"first_name": "MARIUSZ",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-06",
"last_updated": "2007-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "WA",
"license": "PT00008664",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7136021",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0195507",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7603683",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.