NPIMap

Organization Active NPI

Staszak Physical Therapy

  • Physical Therapist
  • Eugene, OR
National Provider Identifier
1770884652
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
STASZAK PHYSICAL THERAPY
Practice address
488 E 11TH Ave Ste 3a
Eugene, OR 97401-3601
Phone
(541) 505-8180
Fax
(541) 505-7134
NPI assigned
Nov 9, 2010
Last updated
Aug 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Authorized official

Name
Mr. Mike Staszak
Title
Owner
Phone
(541) 505-8180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X

Addresses

Primary practice location

488 E 11TH Ave Ste 3a
Eugene, OR 97401-3601

Mailing address

488 E 11TH Ave
Eugene, OR 97401-3601
Phone (541) 505-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110211000052 OR Part B Supplier - Clinic/Group Practice 1951581750 Receives reassigned benefits from 10 practitioners
Practice locations: Eugene, OR

National Provider Directory

National Provider Directory

Locations

1835 Pearl St
Fl 1
Eugene, OR 97401

1835 Pearl St
Fl First
Eugene, OR 97401
Phone (541) 505-8180

488 E 11th Ave
Eugene, OR 97401
Phone (541) 359-1009

488 E 11th Ave
Ste 150A
Eugene, OR 97401
Phone (541) 505-7134

488 E 11th Ave
Ste 3A
Eugene, OR 97401
Phone (541) 505-8180

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1770884652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 E 11TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013601",
            "telephone_number": "541-505-8180",
            "fax_number": "541-505-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 E 11TH AVE STE 3A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013601",
            "telephone_number": "541-505-8180",
            "fax_number": "541-505-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STASZAK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "STASZAK",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-505-8180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.