Boaz Nyongesa Barasa
Physical Therapy Assistant in South Bend, IN. Individual provider (NPI-1).
NPI number1427698307
StatusActive
Last updated in NPPESJan 8, 2020
Details
- NPI
- 1427698307
- Entity type
- Individual (NPI-1)
- Name
- Boaz Nyongesa Barasa
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 8, 2020
- Certification date
- Jan 8, 2020
- Last updated
- Jan 8, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 06005605A | IN | Yes |
Practice location
17475 Dugdale DrSouth Bend, IN 46635-1545
Phone 574-247-7500
Mailing address
828 Liberty StElkhart, IN 46514-2604
Phone 574-575-8824
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapy Assistant providers in South Bend, IN
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- Tori Ellinger, PTANPI 1750940276
- Todd Ellis, PTANPI 1366816522
- Tanya M Goeller, PTANPI 1174720650
- Jennifer Hammons, PTANPI 1760092985
All 48 Physical Therapy Assistant providers in South Bend · All 3,973 providers in South Bend
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