Nathan Daniel McCormack, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

05014345A Issued in IN

Practice address

502 E 1100 N
Chesterton, IN 46304-9697

Phone

(219) 926-5850

NPI assigned

Oct 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Indiana University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Physical Therapy LLCGroup PAC ID 0941506406, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Innovative Physical Therapy LLC

  • Physical Therapist
  • Chesterton, IN
  • NPI 1578937447

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1760144810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 STATE ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426076",
            "telephone_number": "765-810-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E 1100 N",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463049697",
            "telephone_number": "219-926-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 Morthland Dr",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463836204",
            "country_code": "US",
            "telephone_number": "219-242-8803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "NATHAN",
        "middle_name": "DANIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IN",
            "license": "05014345A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Louise Matejczyk
• Daniela Matijevich, DPM,MS
• Ashley Catherine Matthews
• Nichole Marie Matuszak, DPT
• Alexandra Demetria McBurnie, OD
• Anthony M. McCrovitz, PH.D.
• Alicia McDaniel, APRN
• Marlee Y McGrath
• Natalie Celeste McGrogan, RBT
• Brian Christopher McGue, DDS

• Orthopedic Physical Therapist in Chesterton, IN
• Providers in Chesterton, IN by specialty
• Orthopedic Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.