Individual provider Active NPI

Josiah D. Polito, DPT

  • Physical Therapist
  • Manchester, IA
National Provider Identifier
1982992848
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004743 Issued in IA
Practice address
1210 West Main St.
Manchester, IA 52057-2305
Phone
(563) 927-1499
Fax
(563) 927-1489
NPI assigned
Jul 13, 2011
Last updated
Nov 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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 004743 IA Primary

Addresses

Primary practice location

1210 West Main St.
Manchester, IA 52057-2305

Mailing address

1129 11TH St SE
Suite a
Dyersville, IA 52040-2050
Phone (563) 875-8615

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111107000221 IA Practitioner - Physical Therapist in Private Practice 0446423537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason J. Putz Physical Therapy P.C.Group PAC ID 2769578657, 18 clinicians

Practice addresses (Care Compare)

1129 11TH St SE
Suite a
Dyersville, IA 52040-2418

1129 11TH St SE a
Dyersville, IA 52040-2418
Phone (563) 875-8615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004743IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason J. Putz Physical Therapy P.C. CurrentSince Jul 1, 2011 Accepting new patients

Locations

1129 11th St SE
Ste A
Dyersville, IA 52040
Phone (563) 875-8615

107 S 11th St
Ste 1
Manchester, IA 52057
Phone (563) 927-1499

1210 W Main St
Manchester, IA 52057
Phone (563) 927-1499

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, 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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1982992848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 11TH ST SE",
            "address_2": "SUITE A",
            "city": "DYERSVILLE",
            "state": "IA",
            "postal_code": "520402050",
            "telephone_number": "563-875-8615",
            "fax_number": "563-875-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WEST MAIN ST.",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520572305",
            "telephone_number": "563-927-1499",
            "fax_number": "563-927-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "JOSIAH",
        "middle_name": "D.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.