Individual provider Active NPI

Ivan Kirincic

  • Physical Therapist
  • Delaware, OH
National Provider Identifier
1669880860
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016135 Issued in OH
Practice address
7853 Pacer Dr Ste 3C
Delaware, OH 43015-7571
Phone
(405) 134-8477
NPI assigned
Jul 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL
Physical Therapist 225100000X PT016135 OH Primary

Addresses

Primary practice location

7853 Pacer Dr Ste 3C
Delaware, OH 43015-7571

Mailing address

7853 Pacer Dr Ste 3C
Delaware, OH 43015-7571
Phone (740) 513-4847

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241105002404 OH Practitioner - Physical Therapist in Private Practice 9537482245 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohrh, LLC Physical Therapist CurrentSince Sep 25, 2024 Accepting new patients
Ohrh, LLC CurrentSince Sep 25, 2024 Accepting new patients
Ohrh, LLC Current Accepting new patients
Ohrh, LLC PastSince Oct 6, 2024 Accepting new patients

Locations

6021 Cleveland Ave
Columbus, OH 43231
Phone (614) 224-1090

7853 Pacer Dr
#3
Delaware, OH 43015
Phone (269) 910-8553

Organizations & group practices 4

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1669880860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7853 PACER DR STE 3C",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430157571",
            "telephone_number": "740-513-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7853 PACER DR STE 3C",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430157571",
            "telephone_number": "405-134-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRINCIC",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.