Kyota Shizuku, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2418 Issued in MT

Practice address

107 Ridgewater Dr
Polson, MT 59860-8977

Phone

(406) 883-3737

Fax

(406) 883-2669

NPI assigned

Sep 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Community HospitalGroup PAC ID 5496659567, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St. Lukes Community Hospital

  dba St. Luke Community Clinic St. Ignatius

  • Rural Health Clinic/Center
  • St Ignatius, MT
  • NPI 1306911169
  Medicare reassignment Care Compare group NPD
• St Lukes Community Hospital

  dba St. Luke Community Specialty Clinic

  • Certified Registered Nurse Anesthetist
  • Ronan, MT
  • NPI 1518663608
  NPD
• St. Lukes Community Hospital

  dba St. Luke Community Clinic Polson

  • Rural Health Clinic/Center
  • Polson, MT
  • NPI 1184785420
  NPD

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1336576016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 6TH AVE SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642634",
            "telephone_number": "406-676-4441",
            "fax_number": "406-676-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RIDGEWATER DR",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608977",
            "telephone_number": "406-883-3737",
            "fax_number": "406-883-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIZUKU",
        "first_name": "KYOTA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-26",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "2418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Harold Schwartz
• Hemlata Shah
• Stephen Andrew Shepro, PA-C
• Thomas E Sherry, M.D.
• Wade Paul Shipley, PA-C
• Elizabeth Ann Sidebottom, RPH
• Gayle R. Siemers, D.D.S.
• David J. Sievert, D.D.S.
• Wendy Sitter, PT
• Adam T Smith, D.O.

• Physical Therapist in Polson, MT
• Providers in Polson, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.