Individual provider Active NPI

Thomas Kowalski, PT

  • Physical Therapist
  • Hamburg, NY
National Provider Identifier
1366786535
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
035731 Issued in NY
Practice address
3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone
(716) 649-0444
Fax
(716) 649-0420
NPI assigned
Nov 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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 035731 NY Primary

Addresses

Primary practice location

3040 Amsdell Rd
Hamburg, NY 14075-5835

Mailing address

3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone (716) 649-0444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150109002153 SC Practitioner - Physical Therapist in Private Practice 1850536111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Physical Therapy LLCGroup PAC ID 9537422613, 2 clinicians

Practice addresses (Care Compare)

9347 Founders St
Suite a
Fort Mill, SC 29708-6417
Phone (803) 630-5788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7574SCMDProfessional Counselor
035731NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Focus, Inc. CurrentSince Nov 3, 2014 Accepting new patients
Core Physical Therapy LLC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
Ivyrehab Focus, Inc. Physical Therapist CurrentSince Nov 3, 2014 Accepting new patients
Performance Sports Physical Therapy PC Physical Therapist Past Accepting new patients

Locations

130 Crisanto Ave
Ste A
Fort Mill, SC 29715
Phone (803) 487-5638

9347 Founders St
#A
Fort Mill, SC 29708
Phone (716) 465-0883

439 Channel Rd
Ste 102
Lake Wylie, SC 29710
Phone (619) 977-0480

Organizations & group practices 4

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": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1366786535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755835",
            "telephone_number": "716-649-0444",
            "fax_number": "716-649-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755835",
            "telephone_number": "716-649-0444",
            "fax_number": "716-649-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.