Dynamic Physical Therapy Services LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

103 Issued in MA

Legal business name

DYNAMIC PHYSICAL THERAPY SERVICES LLC

Practice address

111 Elm St
Suite 103
Worcester, MA 01609-1967

Phone

(508) 799-6538

Fax

(508) 799-5535

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Michael Buslov

Title

Partner

Phone

(508) 799-6538

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer L Gorman, PT

  • Physical Therapist
  • Worcester, MA
  • NPI 1770800765
  Medicare reassignment Care Compare group NPD
• Robert Sadowski, PT

  • Physical Therapist
  • Worcester, MA
  • NPI 1417013871
  Medicare reassignment Care Compare group NPD
• Danielle Grondine, DPT

  • Physical Therapist
  • Worcester, MA
  • NPI 1033788682
  Medicare reassignment NPD

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801952163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "address_2": "SUITE 103",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967",
            "telephone_number": "508-799-6538",
            "fax_number": "508-799-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "address_2": "SUITE 103",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967",
            "telephone_number": "508-799-6538",
            "fax_number": "508-799-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PHYSICAL THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUSLOV",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "508-799-6538"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9733451",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA27170",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "968564",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y61418",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0036268",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kadijatu Dyfan
• David L. Dykhuizen, M.D.
• Linda Dylewicz, PT
• Christine Kay Dymek, DPT
• Kristin E Dymek, PT
• Dynasty Staffing
• Anyeley Dzanka-Sowah
• Mary T Dziedzinski, LICSW
• Destiny Dziengiel
• Ian E. Dziewietin, PA-C

• Physical Therapist in Worcester, MA
• Providers in Worcester, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.