Individual provider Active NPI

Nicholas R Notario, RPT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1366417768
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1103492 Issued in KS
Practice address
545 N Carriage Pkwy
Wichita, KS 67208-4506
Phone
(316) 612-4900
Fax
(316) 612-4999
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1103492 KS Primary

Addresses

Primary practice location

545 N Carriage Pkwy
Wichita, KS 67208-4506

Mailing address

545 N Carriage Pkwy
Wichita, KS 67208-4506
Phone (316) 612-4900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070309000417 KS Practitioner - Physical Therapist in Private Practice 7315040409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Physical TherapyGroup PAC ID 8426011578, 3 clinicians

Practice addresses (Care Compare)

545 N Carriage Pkwy
Wichita, KS 67208-4506
Phone (316) 612-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1103492KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Physical Therapy Physical Therapist CurrentSince Sep 9, 2008 Accepting new patients

Locations

545 N Carriage Pkwy
Wichita, KS 67208
Phone (316) 612-4900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1366417768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N CARRIAGE PKWY",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084506",
            "telephone_number": "316-612-4900",
            "fax_number": "316-612-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N CARRIAGE PKWY",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672084506",
            "telephone_number": "316-612-4900",
            "fax_number": "316-612-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTARIO",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1103492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.