Individual provider Active NPI

William Alexander Hvizdzak, PT, DPT

  • Physical Therapist
  • Warner Robins, GA
National Provider Identifier
1912675950
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015578 Issued in GA
Practice address
3051 Watson Blvd Ste 525
Warner Robins, GA 31093-8556
Phone
(478) 953-4563
NPI assigned
Sep 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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 PT015578 GA Primary

Addresses

Primary practice location

3051 Watson Blvd Ste 525
Warner Robins, GA 31093-8556

Mailing address

145 Woodard Rd
Kathleen, GA 31047-2601
Phone (478) 542-4825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211112000835 GA Practitioner - Physical Therapist in Private Practice 0042609026 Reassigns benefits to 1 organization
I20260603002710 MT Practitioner - Physical Therapist in Private Practice 0042609026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dodge Works PT, Inc Dba Alpine Physical TherapyGroup PAC ID 0749285179, 32 clinicians
Houston Orthopedic Surgery and Sports Medicine, P.C.Group PAC ID 5092703835, 19 clinicians

Practice addresses (Care Compare)

150 E Spruce St
Suite a
Missoula, MT 59802-4504
Phone (406) 549-0064

3051 Watson Blvd
Suite 525
Warner Robins, GA 31093-8556
Phone (478) 953-4563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015578GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Orthopedic Surgery & Sports Medicine, P.C. CurrentSince Sep 16, 2021 Accepting new patients
Houston Orthopedic Surgery & Sports Medicine, P.C. CurrentSince Sep 16, 2021 Accepting new patients

Locations

1013 Main St
Perry, GA 31069
Phone (478) 953-4563

3051 Watson Blvd
Ste 525
Warner Robins, GA 31093
Phone (478) 953-4563

3051 Watson Blvd
Warner Robins, GA 31093
Phone (478) 953-4563

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": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1912675950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 WOODARD RD",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310472601",
            "telephone_number": "478-542-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 WATSON BLVD STE 525",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310938556",
            "telephone_number": "478-953-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HVIZDZAK",
        "first_name": "WILLIAM",
        "middle_name": "ALEXANDER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.