Individual provider Active NPI

Jason Kucharski, PT, OCS

  • Orthopedic Physical Therapist
  • Wadsworth, OH
National Provider Identifier
1619966637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT08626 Issued in OH
Practice address
145 Smokerise Dr
Wadsworth, OH 44281-8702
Phone
(330) 335-4200
Fax
(330) 335-7131
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT08626 OH Primary

Addresses

Primary practice location

145 Smokerise Dr
Wadsworth, OH 44281-8702

Mailing address

145 Smokerise Dr
Wadsworth, OH 44281-8702
Phone (330) 335-4200

Other identifiers 1

IdentifierTypeStateIssuer
2293987MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060818000158 OH Practitioner - Physical Therapist in Private Practice 0042213845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

34143 Ctr Ridge Rd
North Ridgeville, OH 44039-3221
Phone (440) 327-0299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PT08626OHMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Joint Rehabilitation Inc. Orthopedic CurrentSince Jul 10, 2006 Accepting new patients
Wadsworth Family Physical Therapy Inc Orthopedic PastSince Apr 1, 1995 Accepting new patients

Locations

34143 Center Ridge Rd
North Ridgeville, OH 44039
Phone (216) 225-7054

Organizations & group practices 2

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619966637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 SMOKERISE DR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818702",
            "telephone_number": "330-335-4200",
            "fax_number": "330-335-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 SMOKERISE DR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818702",
            "telephone_number": "330-335-4200",
            "fax_number": "330-335-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHARSKI",
        "first_name": "JASON",
        "credential": "PT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT08626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2293987",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.