Active NPI
Ian Michael Tomczak, DPT
- Physical Therapist
- Dallas, TX
National Provider Identifier
1770128969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 044548-01
- Practice address
- 1755 Wittington PL Ste 175
Dallas, TX 75234-1905 - Phone
- (866) 221-5405
- NPI assigned
- Nov 12, 2019
- 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 | 044548-01 | NY | Primary |
Addresses
Primary practice location
1755 Wittington PL Ste 175
Dallas, TX 75234-1905
Mailing address
7058 Akron Rd
Lockport, NY 14094-6204
Phone (716) 946-0846
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
| License | State | Type | Specialty |
|---|---|---|---|
| 044548-01 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1770128969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7058 AKRON RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140946204",
"telephone_number": "716-946-0846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 WITTINGTON PL STE 175",
"city": "DALLAS",
"state": "TX",
"postal_code": "752341905",
"telephone_number": "866-221-5405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMCZAK",
"first_name": "IAN",
"middle_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-12",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "044548-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.