Individual provider Active NPI

Michael A. Kamienski, LPT

  • Physical Therapist
  • Canton, OH
National Provider Identifier
1457438780
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04591 Issued in OH
Practice address
4218 Hills and Dales Rd NW
Canton, OH 44708-1658
Phone
(330) 477-9005
Fax
(330) 478-1004
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 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 PT04591 OH Primary

Addresses

Primary practice location

4218 Hills and Dales Rd NW
Canton, OH 44708-1658

Mailing address

4218 Hills and Dales Rd NW
Canton, OH 44708-1658
Phone (330) 477-9005

Other identifiers 3

IdentifierTypeStateIssuer
000000167902OtherOHANTHEM
2083981MedicaidOH
64-00435OtherOHUNITEDHEALTHCARE

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Works, Inc. Physical Therapist PastSince Apr 1, 1994 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1457438780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4218 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081658",
            "telephone_number": "330-477-9005",
            "fax_number": "330-478-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081658",
            "telephone_number": "330-477-9005",
            "fax_number": "330-478-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMIENSKI",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT04591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000167902",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083981",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "64-00435",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.