Individual provider Active NPI

Daniel Joseph Vodzak

  • Physical Therapist
  • Springfield, OR
National Provider Identifier
1316391568
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64649 Issued in OR
Practice address
5707 Main St
Springfield, OR 97478-5426
Phone
(541) 650-6972
NPI assigned
Apr 13, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 64649 OR Primary

Addresses

Primary practice location

5707 Main St
Springfield, OR 97478-5426

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Other practice location 1

3 Reed Dr
Marysville, PA 17053-9763
Phone (717) 825-8714

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230421002239 OR Practitioner - Physical Therapist in Private Practice 6800251018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1777 Coburg Rd
Suite 3
Eugene, OR 97401-5477
Phone (541) 505-8041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64649ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist Current Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Jan 13, 2023 Accepting new patients

Locations

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

1777 Coburg Rd
Ste 3
Eugene, OR 97401
Phone (541) 505-8041

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

5707 Main St
Springfield, OR 97478
Phone (541) 650-6972

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1316391568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785426",
            "telephone_number": "541-650-6972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Reed Dr",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "PA",
            "postal_code": "170539763",
            "country_code": "US",
            "telephone_number": "717-825-8714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VODZAK",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.