Individual provider Active NPI

Tomasz Bodzianowski, P.T.

  • Physical Therapist
  • Daly City, CA
National Provider Identifier
1649203779
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26572 Issued in CA
Practice address
45 Southgate Ave Ste 201
Daly City, CA 94015-1413
Phone
(650) 985-7588
NPI assigned
Jul 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Physical Therapist 225100000X 26572 CA Primary

Addresses

Primary practice location

45 Southgate Ave Ste 201
Daly City, CA 94015-1413

Mailing address

810 Antoinette LN Apt C
South San Francisco, CA 94080-3323
Phone (650) 273-1810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26572CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649203779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ANTOINETTE LN APT C",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803323",
            "telephone_number": "650-273-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SOUTHGATE AVE STE 201",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151413",
            "telephone_number": "650-985-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODZIANOWSKI",
        "first_name": "TOMASZ",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.