Individual provider Active NPI

Tomasz J Nosarzewski, PT

  • Physical Therapist
  • Crossville, TN
National Provider Identifier
1407805385
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000003608 Issued in TN
Practice address
29 Taylor Ave
Suite 205
Crossville, TN 38555-4526
Phone
(931) 456-5757
Fax
(931) 456-5533
NPI assigned
May 9, 2006
Last updated
Sep 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 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 PT0000003608 TN Primary

Addresses

Primary practice location

29 Taylor Ave
Suite 205
Crossville, TN 38555-4526

Mailing address

139 Hedgewood PT
Crossville, TN 38558-4514
Phone (931) 456-5757

Other identifiers 2

IdentifierTypeStateIssuer
5726340001OtherTNMEDICARE DME
650021404OtherTNRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050930000513 TN Practitioner - Physical Therapist in Private Practice 1355376021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Rehabilitation Center, PLLCGroup PAC ID 3577639889, 2 clinicians

Practice addresses (Care Compare)

29 Taylor Ave
Suite 205
Crossville, TN 38555-4537

50 Stanley St
Crossville, TN 38555-4430
Phone (931) 456-5757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0000003608TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Center, PLLC Physical Therapist CurrentSince May 23, 2008 Accepting new patients

Locations

29 Taylor Ave
Ste 205
Crossville, TN 38555
Phone (931) 456-5757

50 Stanley St
Crossville, TN 38555
Phone (931) 456-5757

50 Stanley St
Ste 101
Crossville, TN 38555
Phone (931) 456-5757

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1407805385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HEDGEWOOD PT",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385584514",
            "telephone_number": "931-456-5757",
            "fax_number": "931-456-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 TAYLOR AVE",
            "address_2": "SUITE 205",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554526",
            "telephone_number": "931-456-5757",
            "fax_number": "931-456-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSARZEWSKI",
        "first_name": "TOMASZ",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000003608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "5726340001",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650021404",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.