NPIMap

Organization Active NPI

Blasczyk Physical Therapy

  • Physical Therapist
  • Santa Cruz, CA
National Provider Identifier
1417014184
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12676 Issued in CA
Legal business name
BLASCZYK PHYSICAL THERAPY
Practice address
3319B Mission Dr
Santa Cruz, CA 95065-1827
Phone
(831) 465-0107
Fax
(831) 465-0109
NPI assigned
Jan 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Judy Ann Blasczyk, PTNPI 1356374763
Title
Owner
Phone
(831) 465-0107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT12676 CA Primary

Addresses

Primary practice location

3319B Mission Dr
Santa Cruz, CA 95065-1827

Mailing address

3319B Mission Dr
Santa Cruz, CA 95065-1827
Phone (831) 465-0107

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417014184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319B MISSION DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651827",
            "telephone_number": "831-465-0107",
            "fax_number": "831-465-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319B MISSION DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651827",
            "telephone_number": "831-465-0107",
            "fax_number": "831-465-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLASCZYK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLASCZYK",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-465-0107",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.