Individual provider Active NPI

William Lukasiewicz, M.ED. ATC

  • Athletic Trainer
  • Philadelphia, PA
National Provider Identifier
1942758743
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT001161A Issued in PA
Practice address
5600 City Ave
Saint Joseph'S University Sports Medicine
Philadelphia, PA 19131-1308
Phone
(610) 660-3234
Fax
(610) 660-2577
NPI assigned
Sep 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT001161A PA Primary

Addresses

Primary practice location

5600 City Ave
Saint Joseph'S University Sports Medicine
Philadelphia, PA 19131-1308

Mailing address

5600 City Ave
Saint Joseph'S University Sports Medicine
Philadelphia, PA 19131-1308
Phone (610) 660-3234

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
RT001161APAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1942758743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 CITY AVE",
            "address_2": "SAINT JOSEPH'S UNIVERSITY SPORTS MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311308",
            "telephone_number": "610-660-3234",
            "fax_number": "610-660-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 CITY AVE",
            "address_2": "SAINT JOSEPH'S UNIVERSITY SPORTS MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311308",
            "telephone_number": "610-660-3234",
            "fax_number": "610-660-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASIEWICZ",
        "first_name": "WILLIAM",
        "credential": "M.ED. ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT001161A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.