Breakout Advisors and Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BREAKOUT ADVISORS AND REHABILITATION LLC

Practice address

10 N Meadows Dr
Suite 10
Wexford, PA 15090-8367

Phone

(724) 934-6813

Fax

(724) 934-6814

NPI assigned

Jan 11, 2016

Last updated

May 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay O Lemcke, ATC,PT,OCSNPI 1851396634

Title

President

Phone

(724) 934-6813

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jay O Lemcke, PT, ATC, OCS

  • Physical Therapist
  • Wexford, PA
  • NPI 1851396634
  Medicare reassignment Care Compare group NPD Authorized official
• Amy Nguyen

  • Physical Therapist
  • Wexford, PA
  • NPI 1336903756
  Medicare reassignment Care Compare group NPD
• Bradley A Stotsky, DPT

  • Physical Therapist
  • Wexford, PA
  • NPI 1619116035
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1740646454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MEADOWS DR",
            "address_2": "SUITE 10",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908367",
            "telephone_number": "724-934-6813",
            "fax_number": "724-934-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MEADOWS DR",
            "address_2": "SUITE 10",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908367",
            "telephone_number": "724-934-6813",
            "fax_number": "724-934-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKOUT ADVISORS AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "LEMCKE",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-934-6813",
        "authorized_official_credential": "ATC,PT,OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brain Health Center, Inc
• Caitlin Rose Branduzzi, OT
• Jesse Brant
• Sonia Brar, MD
• Jason Braun, PSYD
• Kathleen A. Brenckle, MSW, LCSW
• Jillian Brennan, MS
• Natalie Leighton Brenner, AUD
• Krista Renee Breon, M.S., OTR/L
• Jeannine Marie Brevik, M.D.

• Physical Therapist in Wexford, PA
• Providers in Wexford, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.