Active NPI
Michael J Jaworski, PT
- Physical Therapist
- Elyria, OH
National Provider Identifier
1487603940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT02337
- Practice address
- 137 Winckles Street
Elyria, OH 44035 - Phone
- (440) 366-5993
- Fax
- (440) 366-5313
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT02337 | OH | Primary |
Addresses
Primary practice location
137 Winckles Street
Elyria, OH 44035
Mailing address
137 Winckles Street
Elyria, OH 44035
Phone (440) 366-5993
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4297901 | Other | MEDICARE PTAN | |
| 341490517034 | Other | OH | CARESOURCE |
| 654140 | Other | OH | AETNA |
| 000000132802 | Other | OH | ANTHEM BLUECROSS BLUESHIE |
| 34149051700 | Other | OH | OHIO BUREAU OF WORKERS CO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT02337 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325116800000",
"number": "1487603940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 WINCKLES STREET",
"city": "ELYRIA",
"state": "OH",
"postal_code": "44035",
"telephone_number": "440-366-5993",
"fax_number": "440-366-5313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 WINCKLES STREET",
"city": "ELYRIA",
"state": "OH",
"postal_code": "44035",
"telephone_number": "440-366-5993",
"fax_number": "440-366-5313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAWORSKI",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2011-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT02337",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "4297901",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "341490517034",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "654140",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUECROSS BLUESHIE",
"identifier": "000000132802",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO BUREAU OF WORKERS CO",
"identifier": "34149051700",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.