Individual provider Active NPI

Nicholas Fresenko, DPT

  • Physical Therapist
  • Toledo, OH
National Provider Identifier
1508447624
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4235 Secor Rd
Toledo, OH 43623-4299
Phone
(419) 479-5960
Fax
(419) 479-5435
NPI assigned
Apr 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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 Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4299

Mailing address

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561

Other practice location 1

4900 N McCord Rd Ste A1
Sylvania, OH 43560-3195
Phone (419) 517-1040

Other practice location 2

118 Market Place Cir Ste D
Georgetown, KY 40324-7401
Phone (859) 300-1335

Other identifiers 1

IdentifierTypeStateIssuer
0067318MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240927001011 OH Practitioner - Physical Therapist in Private Practice 0941609424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 874-3246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated CurrentSince Aug 15, 2024 Accepting new patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated CurrentSince Aug 15, 2024 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients
Agilitas USA Inc Past Accepting new patients

Locations

4900 N McCord Rd
Ste A1A
Sylvania, OH 43560
Phone (419) 517-1040

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1508447624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-479-5960",
            "fax_number": "419-479-5435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 N McCord Rd Ste A1",
            "address_purpose": "LOCATION",
            "city": "Sylvania",
            "state": "OH",
            "postal_code": "435603195",
            "country_code": "US",
            "telephone_number": "419-517-1040",
            "fax_number": "419-517-1080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Market Place Cir Ste D",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403247401",
            "country_code": "US",
            "telephone_number": "859-300-1335",
            "fax_number": "859-310-7190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRESENKO",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067318",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.