Active NPI
James Walczak
- Physical Therapist
- Herkimer, NY
National Provider Identifier
1760012264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 104 N Washington St
Herkimer, NY 13350-2028 - Phone
- (315) 866-6964
- Fax
- (315) 574-0030
- NPI assigned
- Jan 23, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
104 N Washington St
Herkimer, NY 13350-2028
Mailing address
104 N Washington St
Herkimer, NY 13350-2028
Phone (315) 866-6964
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579737600000",
"number": "1760012264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 N WASHINGTON ST",
"city": "HERKIMER",
"state": "NY",
"postal_code": "133502028",
"telephone_number": "315-866-6964",
"fax_number": "315-574-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 N WASHINGTON ST",
"city": "HERKIMER",
"state": "NY",
"postal_code": "133502028",
"telephone_number": "315-866-6964",
"fax_number": "315-574-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCZAK",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-23",
"last_updated": "2020-01-23",
"certification_date": "2020-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herkimer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.