Peter Podbielski, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7846 Issued in AZ

Practice address

4110 N 108 Ave
#103
Phoenix, AZ 85037

Phone

(623) 877-9915

Fax

(623) 877-1550

NPI assigned

Jan 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complete Physical Therapy IncGroup PAC ID 5698848125, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Complete Physical Therapy Inc

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1548431075
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1871770073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 N 108 AVE",
            "address_2": "#103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85037",
            "telephone_number": "623-877-9915",
            "fax_number": "623-877-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 N 108 AVE",
            "address_2": "#103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85037",
            "telephone_number": "623-877-9915",
            "fax_number": "623-877-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODBIELSKI",
        "first_name": "PETER",
        "credential": "PT DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304771",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LICENSE",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PMRM Investments LLC
• PMRM Medical Service LLC
• PNP Medical LLC
• Dominic Pocci, DPT
• Barbara A Pockaj, M.D.
• Podboys LLC
• Domenic Podix, PHARM D
• Ami Marie Podlesnik, COTA
• Podolak Chiropractic Center LLC
• Tanya Ann Podolak, DC

• Physical Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.