Vadim Ciobanu, PT
Individual provider Active NPI Physical Therapist · Buena Vista, CO
NPI 1679975320 · NPPES record last updated Sep 24, 2014
Key facts
- NPI
- 1679975320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTL.0012950 (CO)
- Practice address
- 301 Hwy 24 North
Buena Vista, CO 81211 - Phone
- (719) 395-3124
- Fax
- (719) 395-3128
- NPI assigned
- Sep 24, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Primacare Rehabilitation P.C.
Practice addresses (Care Compare)
1235 Indian Trail Rd
Suite 200B
Norcross, GA 30093-5553
Phone (470) 359-3945
2576 Lawrenceville Suwanee Rd
Suite 101
Suwanee, GA 30024-7291
Phone (770) 962-4043
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170321000833 | GA | Practitioner - Physical Therapist in Private Practice | 8628391521 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0012950 | CO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL.0012950 | CO | Yes |
Addresses
Primary practice location
301 Hwy 24 North
Buena Vista, CO 81211
Mailing address
310 W 4TH St Apt 403
Winston Salem, NC 27101-2876
Other providers in Buena Vista, CO
- Alexandra Carmichael
- Catholic Health Iniatives Colorado
- Catholic Health Initiatives Colorado
- Central Colorado Prosthetics and Orthotics, LLC
- Audrey Paige Ceschin
- Collegiate Peaks Counseling, LLC
- Collegiate Peaks Eyecare PLLC
- Colorado Autism Consultants
- Colorado Autism Consultants, LLC
- Colorado Autism Consultants, LLC
All providers in Buena Vista, CO · Physical Therapist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.