NPIMap

Organization Active NPI

Hazleton Physical Therapy, LLC

  • Physical Medicine & Rehabilitation Physician
  • Hazle Township, PA
National Provider Identifier
1346330164
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
HAZLETON PHYSICAL THERAPY, LLC
Practice address
1077 N Church St
Hazle Township, PA 18202-1465
Phone
(570) 501-1808
Fax
(855) 635-6308
NPI assigned
Oct 13, 2006
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Mrs. Katherine Oh
Title
Member
Phone
(570) 501-1808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1077 N Church St
Hazle Township, PA 18202-1465

Mailing address

1077 N Church St
Hazle Township, PA 18202-1465
Phone (570) 501-1808

Other identifiers 1

IdentifierTypeStateIssuer
1022051260001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hazleton@fyzical.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061027000293 PA Part B Supplier - Clinic/Group Practice 2264439686 Receives reassigned benefits from 6 practitioners
Practice locations: Hazle Township, PA; Pottsville, PA

National Provider Directory

National Provider Directory

Locations

1324 N Church St
Ste 4
Hazle Township, PA 18202
Phone (570) 501-1808

8 W Broad St
Ste 216
Hazleton, PA 18201
Phone (570) 501-1808

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1346330164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 N CHURCH ST",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182021465",
            "telephone_number": "570-501-1808",
            "fax_number": "855-635-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 N CHURCH ST",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182021465",
            "telephone_number": "570-501-1808",
            "fax_number": "855-635-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZLETON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "OH",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "570-501-1808",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022051260001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hazleton@fyzical.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1077 N Church St",
            "city": "Hazle Township",
            "state": "PA",
            "country_code": "US",
            "postal_code": "182021465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hazle Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.