Andrew Joseph Wolak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12507 Issued in MN

Practice address

923 Hale Lake Pointe
Grand Rapids, MN 55744-9615

Phone

(218) 326-0543

NPI assigned

Jan 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, DE2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Benchmark Physical Therapy of Delaware LLC

  • Physical Therapist
  • Millsboro, DE
  • NPI 1598222390
  Medicare reassignment NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Buckeye, AZ
  • NPI 1467129684
  Medicare reassignment
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Peoria, AZ
  • NPI 1285271684
  NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1497271431
  NPD

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1992456420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PUEBLO TRL",
            "city": "VERNON",
            "state": "NJ",
            "postal_code": "074623148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 HALE LAKE POINTE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557449615",
            "telephone_number": "218-326-0543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 N Greenfield Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852054009",
            "country_code": "US",
            "telephone_number": "862-268-4973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLAK",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32119",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wildwood Mental Health LLC
• Jennifer Lynn Wilson, B.S., LADC
• Jessica Winkels-Hagerl, MS, LPCC
• Wise Minds by Rhea PLLC
• Janet Woehrle, RN, MS, CNS
• Courtney Brook Worlie, OTR/L
• Brandi Worrath, MS, LCP
• Michael Yahnke
• Lori Ylitalo
• Michael C. Young, OD

• Physical Therapist in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.