Individual provider Active NPI

Julia Alexandra Kusak, PTA

  • Physical Therapy Assistant
  • Cedar Park, TX
National Provider Identifier
1295153112
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2091220 Issued in TX
Practice address
1103 Cypress Creek Road
Suite 103
Cedar Park, TX 78613
Phone
(512) 918-0044
Fax
(512) 918-0045
NPI assigned
Mar 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2091220 TX Primary

Addresses

Primary practice location

1103 Cypress Creek Road
Suite 103
Cedar Park, TX 78613

Mailing address

1103 Cypress Creek Road
Suite 103
Cedar Park, TX 78613
Phone (512) 918-0044

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2091220TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1295153112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 CYPRESS CREEK ROAD",
            "address_2": "SUITE 103",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "78613",
            "telephone_number": "512-918-0044",
            "fax_number": "512-918-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 CYPRESS CREEK ROAD",
            "address_2": "SUITE 103",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "78613",
            "telephone_number": "512-918-0044",
            "fax_number": "512-918-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSAK",
        "first_name": "JULIA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2091220",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 29, 2014; 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.