Brian Staniszewski, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.013318 Issued in IL

Practice address

303 N William Kumpf Blvd
Peoria, IL 61605-2507

Phone

(309) 676-5546

NPI assigned

Feb 23, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Koch Family Medicine SC

  • Family Medicine Physician
  • Morton, IL
  • NPI 1376665125
  Medicare reassignment NPD
• Professional Therapy Services, Inc

  • Physical Therapist
  • Pekin, IL
  • NPI 1578615225
  Medicare reassignment NPD

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1558501106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANISZEWSKI",
        "first_name": "BRIAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.013318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary R. Stamm, D.D.S.
• Gavin Stamper
• Audra Marie Stance, BA, MPA
• Jeanine R Standard, PH D LCPC
• Lindsay Alyne Stangeland, M.S., BCBA
• Charity Stanley
• Kaylee Chantel Stanley, APN
• Melissi Lynn Stanley, APN
• Amanda Stanton, DNP
• Liza Carroll Stanton, LSW

• Physical Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.