Individual provider Active NPI

Mark Anthony Bajkowsky, COTA

  • Occupational Therapy Assistant
  • Decatur, TX
National Provider Identifier
1992277271
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
215161 Issued in TX
Practice address
1555 W Business 380
Decatur, TX 76234-3216
Phone
(907) 781-7823
NPI assigned
Dec 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 215161 TX Primary

Addresses

Primary practice location

1555 W Business 380
Decatur, TX 76234-3216

Mailing address

4413 Larner St
The Colony, TX 75056-3173
Phone (862) 258-5313

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

State licenses

LicenseStateTypeSpecialty
215161TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1992277271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 LARNER ST",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750563173",
            "telephone_number": "862-258-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 W BUSINESS 380",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343216",
            "telephone_number": "907-781-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJKOWSKY",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "215161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.