Individual provider Active NPI

Patricia N Barrack, MPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1285735514
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT30338 Issued in AZ
Practice address
2902 W Agua Fria Fwy Ste 1090
Phoenix, AZ 85027-3970
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Sep 26, 2006
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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 LPT30338 AZ Primary

Addresses

Primary practice location

2902 W Agua Fria Fwy Ste 1090
Phoenix, AZ 85027-3970

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other identifiers 2

IdentifierTypeStateIssuer
LPT-30338OtherAZAZ BOARD OF PHYSICAL THERAPY
LICENSE #5041OtherORPHYSICAL THERAPY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190208002001 AZ Practitioner - Physical Therapist in Private Practice 9436179546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2902 W Agua Fria Fwy
Suite 1090
Phoenix, AZ 85027-3970
Phone (602) 648-5444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT30338AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America PLLC Physical Therapist CurrentSince Jun 6, 2022 Accepting new patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince Jun 6, 2022 Accepting new patients
360 Physical Therapy, LLC Past Accepting new patients

Locations

20325 N 51st Ave
Ste 150
Glendale, AZ 85308
Phone (602) 795-6300

2902 W Agua Fria Fwy
Ste 1090
Phoenix, AZ 85027
Phone (620) 648-5444

33300 N 32nd Ave
Ste 230
Phoenix, AZ 85085

33300 N 32nd Ave
Ste 320
Phoenix, AZ 85085

3342 E Greenway Rd
Ste 105
Phoenix, AZ 85032

5355 E High St
Unit 113
Phoenix, AZ 85054

40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140

33777 N Scottsdale Rd
Ste 110
Scottsdale, AZ 85266
Phone (480) 595-2824

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

Organizations & group practices 4

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1285735514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "602-772-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 W AGUA FRIA FWY STE 1090",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273970",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRACK",
        "first_name": "PATRICIA",
        "middle_name": "N",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT30338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BOARD OF PHYSICAL THERAPY",
            "identifier": "LPT-30338",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "LICENSE #5041",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.