Individual provider Active NPI

Peter Charles Barusic Jr., P.T.

  • Orthopedic Physical Therapist
  • Greensboro, NC
National Provider Identifier
1902096357
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
11162 Issued in NC
Practice address
319 W Wendover Ave
Greensboro, NC 27408-8401
Phone
(336) 274-5006
Fax
(336) 274-5033
NPI assigned
Jul 31, 2007
Last updated
Mar 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 11162 NC Primary

Addresses

Primary practice location

319 W Wendover Ave
Greensboro, NC 27408-8401

Mailing address

319 W Wendover Ave
Greensboro, NC 27408-8401
Phone (336) 274-5006

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

State licenses

LicenseStateTypeSpecialty
11162NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Greensboro Physical Therapy & Sports Medicine Services, LLC Orthopedic PastSince Jul 16, 2012 Accepting new patients
Greensboro Physical Therapy and Sports Medicine Services PastSince Aug 28, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1902096357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088401",
            "telephone_number": "336-274-5006",
            "fax_number": "336-274-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088401",
            "telephone_number": "336-274-5006",
            "fax_number": "336-274-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARUSIC",
        "first_name": "PETER",
        "middle_name": "CHARLES",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "11162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.