Individual provider Active NPI

Jayci Shay Sivak, PT

  • Physical Therapist
  • Dickinson, ND
National Provider Identifier
1235966953
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2797 Issued in ND
Practice address
2500 Fairway St
Dickinson, ND 58601-2639
Phone
(701) 946-7500
NPI assigned
Sep 17, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2797 ND Primary

Addresses

Primary practice location

2500 Fairway St
Dickinson, ND 58601-2639

Mailing address

2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 946-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241106002126 ND Practitioner - Physical Therapist in Private Practice 6204360704 Reassigns benefits to 1 organization
I20260106004094 AK Practitioner - Physical Therapist in Private Practice 6204360704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Action Physical Therapy LLCGroup PAC ID 5597095273, 5 clinicians
Bone and Joint Center PCGroup PAC ID 3173416880, 40 clinicians

Practice addresses (Care Compare)

1001 E Bogard Rd
Wasilla, AK 99654-7114
Phone (907) 373-7246

2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 946-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bone & Joint Center PC Physical Therapist CurrentSince Sep 17, 2024 Accepting new patients

Locations

310 N 9th St
Bismarck, ND 58501
Phone (701) 530-8800

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1235966953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012639",
            "telephone_number": "701-946-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012639",
            "telephone_number": "701-946-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVAK",
        "first_name": "JAYCI",
        "middle_name": "SHAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.