Active NPI
Russell Jaffe, PT
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1851956528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-003354
- Practice address
- 4050 E Cotton Center Blvd
Phoenix, AZ 85040-8861 - Phone
- (480) 795-7330
- Fax
- (602) 296-5622
- NPI assigned
- May 7, 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 | LPT-003354 | AZ | Primary |
Addresses
Primary practice location
4050 E Cotton Center Blvd
Phoenix, AZ 85040-8861
Mailing address
13304 W Stella LN
Litchfield Park, AZ 85340-5387
Phone (602) 619-3779
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | russell.jaffe@protonmail.com |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557187200000",
"number": "1851956528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13304 W STELLA LN",
"city": "LITCHFIELD PARK",
"state": "AZ",
"postal_code": "853405387",
"telephone_number": "602-619-3779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4050 E COTTON CENTER BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850408861",
"telephone_number": "480-795-7330",
"fax_number": "602-296-5622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "RUSSELL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-07",
"last_updated": "2019-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-003354",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "russell.jaffe@protonmail.com",
"affiliation": "N",
"address_1": "13304 W Stella Ln",
"city": "Litchfield Park",
"state": "AZ",
"country_code": "US",
"postal_code": "853405387",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.