Individual provider Active NPI

Robert A Zoubek, MPT.

  • Physical Therapist
  • Winston Salem, NC
National Provider Identifier
1609091537
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9629 Issued in NC
Practice address
1315 S Hawthorne Rd
Winston Salem, NC 27103-4121
Phone
(336) 917-6000
Fax
(336) 917-6003
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 9629 NC Primary

Addresses

Primary practice location

1315 S Hawthorne Rd
Winston Salem, NC 27103-4121

Mailing address

1315 S Hawthorne Rd
Winston Salem, NC 27103-4121
Phone (336) 917-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000747 NC Practitioner - Physical Therapist in Private Practice 8022206556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aware Physical Therapy LLCGroup PAC ID 1951599489, 2 clinicians

Practice addresses (Care Compare)

1315 S Hawthorne Rd
Winston Salem, NC 27103-4121
Phone (336) 917-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9629NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aware Physical Therapy,LLC CurrentSince Aug 9, 2010 Accepting new patients

Locations

5380 US Highway 158
Ste 205
Advance, NC 27006
Phone (336) 940-6415

1315 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 917-6000

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1609091537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034121",
            "telephone_number": "336-917-6000",
            "fax_number": "336-917-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034121",
            "telephone_number": "336-917-6000",
            "fax_number": "336-917-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOUBEK",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MPT.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.