Individual provider Active NPI

Samuel Jonathan Rakyta II, DPT

  • Physical Therapist
  • Hubbard, OH
National Provider Identifier
1497984132
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 012451 Issued in OH
Practice address
609 W Liberty St
Hubbard, OH 44425-1750
Phone
(330) 534-8500
Fax
(330) 534-3926
NPI assigned
Jul 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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 PT 012451 OH Primary

Addresses

Primary practice location

609 W Liberty St
Hubbard, OH 44425-1750

Mailing address

609 W Liberty St
Hubbard, OH 44425-1750
Phone (330) 534-8500

Other identifiers 3

IdentifierTypeStateIssuer
341877311-00OtherBWC
341877311030OtherOHCARESOURCE
64-97047OtherOHUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090805000300 OH Practitioner - Physical Therapist in Private Practice 1052464294 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Link LLCGroup PAC ID 4587805940, 27 clinicians

Practice addresses (Care Compare)

1675 Lance Pointe Rd
Maumee, OH 43537-1603
Phone (419) 559-5591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 012451OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Link LLC Physical Therapist CurrentSince May 1, 2014 Accepting new patients
Toledo Pain Services, PLL CurrentSince May 1, 2014 Accepting new patients
Sandusky Wellness Center Inc CurrentSince May 1, 2018 Accepting new patients
Brent L. Rubin & Associates Inc CurrentSince May 1, 2014 Accepting new patients
Toledo Pain Services, PLL CurrentSince May 1, 2014 Accepting new patients
Sandusky Wellness DME LLC Past Accepting new patients
Hallett Enterprises, LLC Physical Therapist Past Accepting new patients
Brent L. Rubin & Associates Inc PastSince Aug 11, 2019 Accepting new patients

Locations

106 College Park Dr
Gambier, OH 43022

1675 Lance Pointe Rd
Maumee, OH 43537
Phone (419) 891-9800

433 W Dussel Dr
Maumee, OH 43537

11301 Upper Gilchrist Rd
Ste A
Mount Vernon, OH 43050
Phone (740) 392-1407

403 S Perry St
Napoleon, OH 43545

846 S Coy Rd
Ste 100
Oregon, OH 43616

1090 W South Boundary St
Ste 600
Perrysburg, OH 43551
Phone (419) 873-8280

27121 Oakmead Dr
Perrysburg, OH 43551
Phone (419) 874-8745

3703 Columbus Ave
Sandusky, OH 44870
Phone (419) 625-8085

99 N Main St
Swanton, OH 43558

5200 Harroun Rd
Sylvania, OH 43560
Phone (419) 824-1305

3400 Meijer Dr
Toledo, OH 43617
Phone (419) 531-3500

5151 Monroe St
Ste 104
Toledo, OH 43623

3055 W Sylvania Ave
Toledo, OH 43613
Phone (419) 471-1172

4349 Talmadge Rd
Toledo, OH 43623
Phone (419) 654-8818

4210 W Sylvania Ave
Ste 102
Toledo, OH 43623
Phone (419) 350-3347

108 E Main St
Ste B
Woodville, OH 43469
Phone (419) 849-2900

Organizations & group practices 9

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1497984132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W LIBERTY ST",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444251750",
            "telephone_number": "330-534-8500",
            "fax_number": "330-534-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W LIBERTY ST",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444251750",
            "telephone_number": "330-534-8500",
            "fax_number": "330-534-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKYTA",
        "first_name": "SAMUEL",
        "middle_name": "JONATHAN",
        "name_suffix": "II",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 012451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "341877311-00",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341877311030",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "64-97047",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hubbard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.