Individual provider Active NPI

Michael J Rozyczko, LMT

  • Massage Therapist
  • Syracuse, NY
National Provider Identifier
1881002350
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
27 027939 Issued in NY
Practice address
2605 Brewerton Rd
Syracuse, NY 13211-1147
Phone
(315) 455-9355
NPI assigned
Jul 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 27 027939 NY Primary

Addresses

Primary practice location

2605 Brewerton Rd
Syracuse, NY 13211-1147

Mailing address

2605 Brewerton Rd
Syracuse, NY 13211-1147
Phone (315) 455-9355

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27 027939NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cltoperations, LLC Past Accepting new patients

Organizations & group practices 1

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": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1881002350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 BREWERTON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132111147",
            "telephone_number": "315-455-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 BREWERTON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132111147",
            "telephone_number": "315-455-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZYCZKO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "27 027939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.