Individual provider Active NPI

Eric Niwinski, DPT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1669028288
Registry record updated Jun 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070024659 Issued in IL
Practice address
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone
(505) 846-3200
NPI assigned
Aug 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2023

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 070024659 IL Primary

Addresses

Primary practice location

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Mailing address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone (505) 846-3200

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Mar 3, 2024 Accepting new patients

Locations

3420 N Lincoln Ave
Chicago, IL 60657
Phone (773) 360-7287

1103 S State St
Ste 300
Chicago, IL 60605
Phone (312) 877-5101

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686355200000",
    "number": "1669028288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-846-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-846-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIWINSKI",
        "first_name": "ERIC",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-12",
        "last_updated": "2023-06-10",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2023; 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.