Individual provider Active NPI

Benjamin Joseph Deszczykiewicz, MPT

  • Physical Therapist
  • Chardon, OH
National Provider Identifier
1306024906
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012011 Issued in OH
Practice address
150 7TH Ave Ste 200
Chardon, OH 44024-2909
Phone
(440) 285-4999
Fax
(402) 855-8704
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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 PT012011 OH Primary

Addresses

Primary practice location

150 7TH Ave Ste 200
Chardon, OH 44024-2909

Mailing address

6480 Harrison Ave Ste 201
Cincinnati, OH 45247-7961
Phone (440) 285-4999

Other identifiers 1

IdentifierTypeStateIssuer
2902112MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080304000014 OH Practitioner - Physical Therapist in Private Practice 3678657442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Orthopaedics and Sports Medicine LTDGroup PAC ID 0345136412, 471 clinicians

Practice addresses (Care Compare)

6480 Harrison Ave
Cincinnati, OH 45247-7821
Phone (513) 354-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine, LTD Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Aug 1, 2023 Accepting new patients

Locations

11800 Washington St
Chagrin Falls, OH 44023
Phone (440) 285-6452

150 7th Ave
Ste 200
Chardon, OH 44024
Phone (440) 746-1055

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

890 W Main St
Ste 202
Geneva, OH 44041
Phone (440) 285-5004

15389 W High St
Middlefield, OH 44062
Phone (440) 632-0594

Interoperability endpoints

  • Direct secure messaging: benjamin.deszczykiewicz.p1@direct.beaconortho.nextgenshare.com

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": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1306024906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE STE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "440-285-4999",
            "fax_number": "440-285-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 7TH AVE STE 200",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440242909",
            "telephone_number": "440-285-4999",
            "fax_number": "402-855-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESZCZYKIEWICZ",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT012011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2902112",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.