Individual provider Active NPI

Ty Razo, DPT

  • Physical Therapist
  • Bluffton, IN
National Provider Identifier
1720811896
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05015688A Issued in IN
Practice address
2170 Commerce Dr
Bluffton, IN 46714-9292
Phone
(260) 824-0522
NPI assigned
Aug 23, 2024
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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 05015688A IN Primary

Addresses

Primary practice location

2170 Commerce Dr
Bluffton, IN 46714-9292

Mailing address

4251 Lahmeyer Rd
Fort Wayne, IN 46815-5676
Phone (260) 432-4700

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
05015688AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Indiana Physical Therapy, Inc Physical Therapist PastSince Aug 25, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1720811896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 LAHMEYER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468155676",
            "telephone_number": "260-432-4700",
            "fax_number": "260-459-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 COMMERCE DR",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467149292",
            "telephone_number": "260-824-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZO",
        "first_name": "TY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015688A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.