Individual provider Active NPI

Sakura Staak, LMT

  • Massage Therapist
  • Lake Ariel, PA
National Provider Identifier
1740751569
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
008961 Issued in PA
Practice address
1008 Cheroquee Ter
Lake Ariel, PA 18436-8032
Phone
(203) 685-8222
NPI assigned
Dec 6, 2018
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X CT
Massage Therapist 225700000X 8961 CT
Massage Therapist 225700000X 008961 PA Primary

Addresses

Primary practice location

1008 Cheroquee Ter
Lake Ariel, PA 18436-8032

Mailing address

1008 Cheroquee Ter
Lake Ariel, PA 18436-8032
Phone (203) 685-8222

Other practice location 1

2030 Straits Tpke Ste 3
Middlebury, CT 06762-1831
Phone (203) 685-8222

Other practice location 2

1255 Middlebury Rd
Middlebury, CT 06762-2333
Phone (203) 577-2095

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
8961CTMDMassage Therapist
008961PAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rizza Chiropractic and Wellness, LLC Single Specialty CurrentSince Mar 1, 2020 Accepting new patients
Albert a. Cantito, D.C. PC Single Specialty PastSince Mar 1, 2020 Accepting new patients

Locations

1255 Middlebury Rd
Middlebury, CT 06762
Phone (203) 528-3972

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1740751569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 CHEROQUEE TER",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184368032",
            "telephone_number": "203-685-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 CHEROQUEE TER",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184368032",
            "telephone_number": "203-685-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Straits Tpke Ste 3",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "CT",
            "postal_code": "067621831",
            "country_code": "US",
            "telephone_number": "203-685-8222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 Middlebury Rd",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "CT",
            "postal_code": "067622333",
            "country_code": "US",
            "telephone_number": "203-577-2095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAAK",
        "first_name": "SAKURA",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CT",
            "license": "8961",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "PA",
            "license": "008961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ariel, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.