NPIMap

Organization Active NPI

Takoyaki Innovations LLC

  • Physical Therapy Clinic/Center
  • Glenside, PA
National Provider Identifier
1336983063
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
TAKOYAKI INNOVATIONS LLC
Doing business as
Vertigo Mobile
Practice address
840 Hilldale Rd
Glenside, PA 19038-3810
Phone
(610) 563-1598
NPI assigned
Jun 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Dr. Benjamin David Sacks, PT, DPTNPI 1649633561
Title
Owner
Phone
(610) 563-1598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Health Service Clinic/Center 261QH0100X
Physical Therapy Clinic/Center 261QP2000X Primary
Primary Care Clinic/Center 261QP2300X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

840 Hilldale Rd
Glenside, PA 19038-3810

Mailing address

840 Hilldale Rd
Glenside, PA 19038-3810
Phone (610) 563-1598

Other names 1

  • Vertigo Mobile Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1336983063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 HILLDALE RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190383810",
            "telephone_number": "610-563-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HILLDALE RD",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190383810",
            "telephone_number": "610-563-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKOYAKI INNOVATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "SACKS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-563-1598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vertigo Mobile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenside, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.