Active NPI
Lisa M Polakowski, PT
- Physical Therapist
- Mentor, OH
National Provider Identifier
1225255813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5610
- Practice address
- 7139 Hopkins Rd
Mentor, OH 44060-4438 - Phone
- (440) 423-5577
- NPI assigned
- Apr 18, 2007
- Last updated
- Jan 23, 2019
- Sex
- Female
- 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 | 5610 | OH | Primary |
Addresses
Primary practice location
7139 Hopkins Rd
Mentor, OH 44060-4438
Mailing address
9629 Brayes Manor Dr
Mentor, OH 44060-7133
Phone (440) 341-2702
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5610 | OH | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active RX Rehab and Wellness Center | Physical Therapist | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Concord Township, OH
- NPI 1245794122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1225255813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9629 BRAYES MANOR DR",
"city": "MENTOR",
"state": "OH",
"postal_code": "440607133",
"telephone_number": "440-341-2702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7139 HOPKINS RD",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604438",
"telephone_number": "440-423-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLAKOWSKI",
"first_name": "LISA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "5610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.