Nathan Robert Mayernik, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13483-24 Issued in WI

Practice address

4123 Radio Dr
Suite 100
Woodbury, MN 55129

Phone

(651) 968-5201

NPI assigned

Jun 8, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
  • NPI 1306899463
  Medicare reassignment Care Compare group NPD
• Summit Orthopedics LTD

  • Orthopaedic Surgery Physician
  • Eden Prairie, MN
  • NPI 1417639626
  NPD
• Summit Orthopedics, LTD.

  • Occupational Medicine Clinic/Center
  • Saint Paul, MN
  • NPI 1275684128
  NPD
• Summit Orthopedics LTD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Woodbury, MN
  • NPI 1386007417
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1235588468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 HANLEY RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540169368",
            "telephone_number": "715-386-1155",
            "fax_number": "715-386-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 RADIO DR",
            "address_2": "SUITE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55129",
            "telephone_number": "651-968-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERNIK",
        "first_name": "NATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13483-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Rich Matthews, MD
• Kathleen Mattson
• Lydia Ruth Mattson, MPH, RD
• Mary Lou Mattson, LCSW, DBTC
• Lora Elinore Matz, M.S.,LICSW
• Allyson Carol Maynard, PT, DPT
• Amiyah Kay Mayo
• MB Transportation LLC
• Izaac Mbah Mbah
• David G McAlpine, MD

• Physical Therapist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.