Kenneth David Pasternak, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

9618A Issued in AZ

Practice address

14260 S Denny Blvd
Litchfield Park, AZ 85340-9448

Phone

(623) 536-7400

NPI assigned

Feb 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1285907626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 ROCK LAKE GLN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156442",
            "telephone_number": "704-517-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14260 S DENNY BLVD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409448",
            "telephone_number": "623-536-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTERNAK",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "9618A",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "4607",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2083653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Osier, RBT
• Lin Allen Ozan, PA-C
• Katrina Renee Pacheco, RBT
• Jaime Sue Pack-Adair, EDD
• Cade Joseph Parker, PT, DPT
• Nikita Patel, PA-C
• Pankaj Patil
• Liisa Marie Pawlak
• Matthew Justin Pawlowski, PHARMD
• Richard Francis Pearson Jr., PHARM.D.

• Physical Therapy Assistant in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.