Nathan Michael Nasternak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4382 Issued in NV

Practice address

750 Coronado Center Drive, Suite 140
2212
Henderson, NV 89052

Phone

(702) 312-4878

Fax

(702) 312-4886

NPI assigned

Oct 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1740889112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CORONADO CENTER DRIVE, SUITE 140",
            "address_2": "2212",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-312-4878",
            "fax_number": "702-312-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 CORONADO CENTER DRIVE, SUITE 140",
            "address_2": "2212",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-312-4878",
            "fax_number": "702-312-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASTERNAK",
        "first_name": "NATHAN",
        "middle_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045962",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Henderson, NV
• Providers in Henderson, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; 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.