Individual provider Active NPI

Mark D Blazek, DPT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1306222534
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7901 Issued in SC
Practice address
3250 Harden Street Ext
Suite 100
Columbia, SC 29203-6842
Phone
(803) 509-6389
Fax
(803) 509-6390
NPI assigned
Aug 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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 7901 SC Primary

Addresses

Primary practice location

3250 Harden Street Ext
Suite 100
Columbia, SC 29203-6842

Mailing address

10 William Pope Dr
Suite 3
Bluffton, SC 29909-7549
Phone (843) 705-9440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150921003092 SC Practitioner - Physical Therapist in Private Practice 5496062606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chapin Rehabilitation Clinic IncGroup PAC ID 1557443488, 3 clinicians

Practice addresses (Care Compare)

1525 Chapin Rd
Chapin, SC 29036
Phone (803) 345-3811

Merit-based Incentive Payment System (MIPS)

Final score
91.19 of 100Reported as individual
Quality
82.38
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7901SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Aug 11, 2015 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Aug 11, 2015 Accepting new patients
Chapin Rehabilitation Clinic, Inc. CurrentSince Aug 4, 2021 Accepting new patients
Chapin Physical Therapy LLC Physical Therapist PastSince Aug 4, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

10 William Pope Dr
Ste 3
Bluffton, SC 29909
Phone (843) 705-9440

3250 Harden Street Ext
Ste 100
Columbia, SC 29203
Phone (803) 509-6389

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

Organizations & group practices 5

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1306222534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WILLIAM POPE DR",
            "address_2": "SUITE 3",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299097549",
            "telephone_number": "843-705-9440",
            "fax_number": "843-705-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 HARDEN STREET EXT",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036842",
            "telephone_number": "803-509-6389",
            "fax_number": "803-509-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEK",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.