Individual provider Active NPI

Patrick Jansa, PT, DPT

  • Physical Therapist
  • Denver, CO
National Provider Identifier
1689101701
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14796 Issued in CO
Practice address
1550 S Pearl St Ste 101
Denver, CO 80210-2645
Phone
(303) 778-7246
NPI assigned
May 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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 14796 CO Primary

Addresses

Primary practice location

1550 S Pearl St Ste 101
Denver, CO 80210-2645

Mailing address

1709 S Corona St
Denver, CO 80210-3237
Phone (503) 891-6023

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220916003187 OR Practitioner - Physical Therapist in Private Practice 2062784168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapydia IncGroup PAC ID 2264678226, 35 clinicians

Practice addresses (Care Compare)

4140 N Williams Ave
Portland, OR 97217-2948
Phone (971) 347-1774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14796COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapydia, Inc. Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Coverly Physical Therapy, Inc. CurrentSince May 30, 2017 Accepting new patients
Therapydia, Inc. Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients

Locations

18 E Blithedale Ave
Ste 21
Mill Valley, CA 94941

1550 S Pearl St
Ste 101
Denver, CO 80210
Phone (303) 778-7246

2808 E Burnside St
Portland, OR 97214
Phone (503) 477-4802

4140 N Williams Ave
Portland, OR 97217
Phone (971) 318-1367

3838 SE Powell Blvd
Portland, OR 97202
Phone (503) 603-4555

Organizations & group practices 3

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": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1689101701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 S CORONA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103237",
            "telephone_number": "503-891-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S PEARL ST STE 101",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802102645",
            "telephone_number": "303-778-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSA",
        "first_name": "PATRICK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "14796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.