Individual provider Active NPI

Konstantin Baraz, PT, DPT

  • Physical Therapist
  • Westlake, OH
National Provider Identifier
1972143493
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013974 Issued in OH
Practice address
27569 Detroit Rd
Westlake, OH 44145-2200
Phone
(216) 334-7530
NPI assigned
Jan 13, 2020
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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 013974 OH Primary

Addresses

Primary practice location

27569 Detroit Rd
Westlake, OH 44145-2200

Mailing address

1071 Stanwell Dr
Highland Heights, OH 44143-3237
Phone (216) 334-7530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200424000478 OH Practitioner - Physical Therapist in Private Practice 4688004187 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013974OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Mar 14, 2020 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Mar 14, 2020 Accepting new patients
Lake Orthopaedic Associates, Inc. CurrentSince Oct 6, 2021 Accepting new patients
Chiro Life LLC Physical Therapist CurrentSince Jul 29, 2021 Accepting new patients
Lake Orthopaedic Associates, Inc. CurrentSince Oct 6, 2021 Accepting new patients
Lake Orthopaedic Associates, Inc. Current Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

7211 Center St
Mentor, OH 44060
Phone (440) 205-9910

9500 Mentor Ave
Ste 210
Mentor, OH 44060
Phone (440) 352-0934

36060 Euclid Ave
Ste 104
Willoughby, OH 44094
Phone (440) 352-1711

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBFBCA
  • Direct secure messaging: kbaraz645103@ehrdirect.uhhospitals.org

Organizations & group practices 6

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1972143493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 STANWELL DR",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441433237",
            "telephone_number": "216-334-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27569 DETROIT RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452200",
            "telephone_number": "216-334-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAZ",
        "first_name": "KONSTANTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "013974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.