Individual provider Active NPI

Erek W Latzka, MD, RMSK

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Wellesley, MA
National Provider Identifier
1336587385
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
1014574 Issued in MA
Practice address
20 Walnut St Ste 14
Wellesley, MA 02481-2104
Phone
(781) 591-7855
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 1014574 MA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 1014574 MA Primary

Addresses

Primary practice location

20 Walnut St Ste 14
Wellesley, MA 02481-2104

Mailing address

35 United Dr Ste 102
West Bridgewater, MA 02379-1056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606002175 MA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 9133446677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
Tufts University School of Medicine, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Boston Sports and Biologics PCGroup PAC ID 6002225547, 2 clinicians
Boston Sports and Spine LLCGroup PAC ID 7810335601, 3 clinicians

Practice addresses (Care Compare)

20 Walnut St
Suite 14
Wellesley, MA 02481-2104
Phone (781) 591-7855

Hospital & facility affiliations

  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Sports & Biologics PC Physical Medicine & Rehabilitation CurrentSince Jun 1, 2023 Accepting new patients

Locations

20 Walnut St
Ste 14
Wellesley Hills, MA 02481
Phone (781) 591-7855

35 United Dr
Ste 102
West Bridgewater, MA 02379

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFJDCD/Endpoint/GFJDCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GFJDCD

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1336587385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 UNITED DR STE 102",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023791056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WALNUT ST STE 14",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024812104",
            "telephone_number": "781-591-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATZKA",
        "first_name": "EREK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD, RMSK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "1014574",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MA",
            "license": "1014574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.