Individual provider Active NPI

Robert Sadowski, PT

  • Physical Therapist
  • Worcester, MA
National Provider Identifier
1417013871
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2333 Issued in MA
Practice address
111 Elm St
Suite 103
Worcester, MA 01609-1967
Phone
(508) 799-6538
Fax
(508) 799-5535
NPI assigned
Dec 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 2333 MA Primary

Addresses

Primary practice location

111 Elm St
Suite 103
Worcester, MA 01609-1967

Mailing address

PO Box 671
Douglas, MA 01516-0671
Phone (508) 476-7113

Other identifiers 4

IdentifierTypeStateIssuer
0700185MedicaidMA
3943677OtherMAAETNA CLAIMS #
AA25050OtherMAHARVARD PILGRIM PROVIDER
Y68410OtherMABCBS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040929000455 MA Practitioner - Physical Therapist in Private Practice 2466421128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Physical Therapy Services LLCGroup PAC ID 1254300932, 2 clinicians

Practice addresses (Care Compare)

111 Elm St
Suite 103
Worcester, MA 01609-1921
Phone (508) 799-6538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2333MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Physical Therapy Services LLC Physical Therapist CurrentSince Jul 19, 2004 Accepting new patients
Elm Park Physical Therapy LLC Physical Therapist PastSince Jul 19, 2004 Accepting new patients
Rachel Pressey Physical Therapist Past Accepting new patients
D & R Physical Therapy Physical Therapist Past Accepting new patients

Locations

111 Elm St
Ste 103
Worcester, MA 01609
Phone (508) 799-6538

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, 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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417013871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671",
            "city": "DOUGLAS",
            "state": "MA",
            "postal_code": "015160671",
            "telephone_number": "508-476-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "address_2": "SUITE 103",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967",
            "telephone_number": "508-799-6538",
            "fax_number": "508-799-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADOWSKI",
        "first_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "2333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0700185",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CLAIMS #",
            "identifier": "3943677",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PROVIDER",
            "identifier": "AA25050",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "Y68410",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.