Individual provider Active NPI

Claire Pavlak, PT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1730810516
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT32344 Issued in AZ
Practice address
2560 E Fort Lowell Rd
Tucson, AZ 85716-1514
Phone
(520) 323-9086
Fax
(520) 323-6364
NPI assigned
Jun 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 LPT32344 AZ Primary

Addresses

Primary practice location

2560 E Fort Lowell Rd
Tucson, AZ 85716-1514

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220706001173 AZ Practitioner - Physical Therapist in Private Practice 8426438615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT32344AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

662 S Wilmot Rd
Tucson, AZ 85711
Phone (520) 403-6246

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1730810516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 E FORT LOWELL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857161514",
            "telephone_number": "520-323-9086",
            "fax_number": "520-323-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLAK",
        "first_name": "CLAIRE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT32344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.