Individual provider Active NPI

Ariel Zablocki

  • Physical Therapist
  • Jackson, WY
National Provider Identifier
1295282556
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1641 Issued in WY
Practice address
120 W Pearl Ave Ste F
Jackson, WY 83001-8657
Phone
(307) 734-9129
NPI assigned
Sep 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305210312 VA
Physical Therapist 225100000X 1641 WY Primary

Addresses

Primary practice location

120 W Pearl Ave Ste F
Jackson, WY 83001-8657

Mailing address

PO Box 8857
Jackson, WY 83002-8857
Phone (307) 734-9129

Other practice location 1

2555 Phillips Field Rd Ste 202
Fairbanks, AK 99709-3933
Phone (907) 456-5990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906003265 CA Practitioner - Physical Therapist in Private Practice 5698041408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073
Phone (760) 934-3311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1641WYMDMental Health Counselor
2305210312VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Mono Health Care District CurrentSince Sep 16, 2022 Accepting new patients
Willow Physical Therapy, Limited PastSince Aug 16, 1999 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1295282556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8857",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830028857",
            "telephone_number": "307-734-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W PEARL AVE STE F",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018657",
            "telephone_number": "307-734-9129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 Phillips Field Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997093933",
            "country_code": "US",
            "telephone_number": "907-456-5990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZABLOCKI",
        "first_name": "ARIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210312",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "1641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.