Individual provider Active NPI

Jacek A Szymanowicz, PT

  • Physical Therapist
  • Stuart, FL
National Provider Identifier
1003672791
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12199 Issued in FL
Practice address
4287 SE Federal Hwy
Stuart, FL 34997-4936
Phone
(772) 223-3440
Fax
(772) 225-0843
NPI assigned
Feb 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT12199 FL Primary

Addresses

Primary practice location

4287 SE Federal Hwy
Stuart, FL 34997-4936

Mailing address

4287 SE Federal Hwy
Stuart, FL 34997-4936
Phone (772) 225-8908

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412002194 FL Practitioner - Physical Therapist in Private Practice 8123467933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gina'S Physical Therapy IncGroup PAC ID 5698822740, 3 clinicians

Practice addresses (Care Compare)

4287 SE Federal Hwy
Stuart, FL 34997-4936
Phone (772) 225-8908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT12199FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gina'S Physical Therapy, Inc Single Specialty CurrentSince Mar 5, 2024 Accepting new patients

Locations

4287 SE Federal Hwy
Stuart, FL 34997
Phone (772) 223-3440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1003672791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4287 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349974936",
            "telephone_number": "772-225-8908",
            "fax_number": "772-225-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4287 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349974936",
            "telephone_number": "772-223-3440",
            "fax_number": "772-225-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZYMANOWICZ",
        "first_name": "JACEK",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.