Individual provider Active NPI

Joshua Pond Zajac

  • Physical Therapist
  • Norfolk, VA
National Provider Identifier
1841023140
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305216831 Issued in VA
Practice address
3509 Granby St Ste B1
Norfolk, VA 23504-1312
Phone
(757) 423-8885
NPI assigned
Aug 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305216831 VA Primary

Addresses

Primary practice location

3509 Granby St Ste B1
Norfolk, VA 23504-1312

Mailing address

PO Box 412307
Boston, MA 02241-2307
Phone (914) 294-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250124001229 VA Practitioner - Physical Therapist in Private Practice 6608305370 Reassigns benefits to 1 organization
I20260609001927 UT Practitioner - Physical Therapist in Private Practice 6608305370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians
Reactive Physical Therapy PLLCGroup PAC ID 2264811157, 5 clinicians

Practice addresses (Care Compare)

3509 Granby St
Suite B
Norfolk, VA 23504-1312
Phone (757) 423-8885

550 W 465
Suite 504
Providence, UT 84332-8014
Phone (435) 535-3677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305216831VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Nov 6, 2024 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Nov 6, 2024 Accepting new patients

Locations

2275 Beech Ave
Buena Vista, VA 24416
Phone (540) 466-1000

3509 Granby St
#B
Norfolk, VA 23504
Phone (757) 423-8885

5204 Fairfield Shopping Ctr
Virginia Beach, VA 23464
Phone (757) 467-4603

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1841023140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412307",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412307",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 GRANBY ST STE B1",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041312",
            "telephone_number": "757-423-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "JOSHUA",
        "middle_name": "POND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.