Hannah Brooke Zak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05014209A Issued in IN

Practice address

3946 Ice Way
Fort Wayne, IN 46805-1018

Phone

(260) 266-7400

Fax

(260) 266-4008

NPI assigned

Jun 29, 2021

Last updated

Aug 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Hannah Blystone Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thomas a Brady Sports Medicine Center, PCGroup PAC ID 5991609281, 100 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas a Brady Sports Medicine Center, PC

  dba Forte Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Carmel, IN
  • NPI 1467484212

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• Parkview Ortho Performance Center, LLC

  • Physical Therapist
  • Fort Wayne, IN
  • NPI 1215309976
  NPD
• Thomas a Brady Sports Medicine Center, PC

  dba Forte Sports Medicine and Orthopedics

  • Orthopaedic Surgery Physician
  • Noblesville, IN
  • NPI 1407480239

  Sports Medicine

  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1265002620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3946 ICE WAY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051018",
            "telephone_number": "260-266-7400",
            "fax_number": "260-266-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK",
        "first_name": "HANNAH",
        "middle_name": "BROOKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "IN",
            "license": "05014209A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05014209A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "BLYSTONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas Robert Zachman, O.D.
• Erica L Zachrich, PT
• Annette Lillian Zacur, APRN
• Carina Amira Zahdeh, MD
• Jacquelyne Zahner
• Nayeli Zamora
• Maria Soledad Zamudio Nino
• Darwin Zapeta Hernandez
• Jodi Zartman
• Margaret Zartman

• Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.