Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephen Pietzak

Individual provider Physical Therapist · NPI 1912372731

Stephen Pietzak is a Physical Therapist in Private Practice in Smithtown, New York. Qualified in 2014, 12 years ago. Practices with 360 Physical Therapy LLC, a 85-clinician group and accepts Medicare assignment. Licensed in Arizona and New York.

Years since qualifying
12
Licensed in
AZ, NY
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

309 E Middle Country Rd
Smithtown, NY 11787-2844
Phone: (631) 656-5665
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence LPT-30042 (AZ)
Physical Therapist Taxonomy 225100000X · Licence 039578 (NY)

Record details

NPI number1912372731
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 4, 2015
Last updated in NPPESJuly 23, 2026
Certification dateJuly 23, 2026
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice 360 Physical Therapy Llc — 85 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Smithtown