Individual provider Active NPI

Justin Nykiel, PT, DPT

  • Physical Therapist
  • Cedar Park, TX
National Provider Identifier
1245778463
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1287270 Issued in TX
Practice address
2519 S Lakeline Blvd
Ste 100
Cedar Park, TX 78613-2964
Phone
(512) 331-6200
Fax
(512) 331-6384
NPI assigned
Feb 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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 1287270 TX Primary

Addresses

Primary practice location

2519 S Lakeline Blvd
Ste 100
Cedar Park, TX 78613-2964

Mailing address

2519 S Lakeline Blvd
Ste 100
Cedar Park, TX 78613-2964
Phone (512) 331-6200

Other identifiers 1

IdentifierTypeStateIssuer
1287270OtherTXTEXAS PT LICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1245778463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 S LAKELINE BLVD",
            "address_2": "STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "512-331-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 S LAKELINE BLVD",
            "address_2": "STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "512-331-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYKIEL",
        "first_name": "JUSTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1287270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PT LICENSE",
            "identifier": "1287270",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.