Active NPI
Amy L. Trzaska, MSPT
- Pediatric Physical Therapist
- Scarborough, ME
National Provider Identifier
1417155615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2774
- Practice address
- 198 Spurwink Rd
Scarborough, ME 04074-8602 - Phone
- (207) 205-3435
- NPI assigned
- Jul 10, 2007
- Last updated
- Aug 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2774 | ME | Primary |
Addresses
Primary practice location
198 Spurwink Rd
Scarborough, ME 04074-8602
Mailing address
198 Spurwink Rd
Scarborough, ME 04074-8602
Phone (207) 205-3435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2774 | Other | ME | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2774 | ME | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313366400000",
"number": "1417155615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 SPURWINK RD",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040748602",
"telephone_number": "207-205-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 SPURWINK RD",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040748602",
"telephone_number": "207-205-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRZASKA",
"first_name": "AMY",
"middle_name": "L.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2011-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "ME",
"license": "2774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "2774",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.