Individual provider Active NPI

Jonathan Walter Kupiec, PT

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1023849759
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0020057 Issued in CO
Practice address
701 Delaware Ave Unit E
Longmont, CO 80501-6498
Phone
(720) 204-4567
NPI assigned
Aug 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0020057 CO Primary

Addresses

Primary practice location

701 Delaware Ave Unit E
Longmont, CO 80501-6498

Mailing address

701 Delaware Ave Unit E
Longmont, CO 80501-6498
Phone (720) 204-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240914000760 CO Practitioner - Physical Therapist in Private Practice 9537609722 Reassigns benefits to 1 organization
I20251211001930 CA Practitioner - Physical Therapist in Private Practice 9537609722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monterey Spine and Joint PCGroup PAC ID 0840295721, 75 clinicians
Crafted Physical Therapy PLLCGroup PAC ID 3779839170, 9 clinicians

Practice addresses (Care Compare)

21 Lower Ragsdale Dr
Monterey, CA 93940-5827
Phone (831) 648-7200

701 Delaware Ave
Unit E
Longmont, CO 80501-6498
Phone (303) 729-1447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Spine & Joint PC CurrentSince Dec 15, 2025 Accepting new patients
Monterey Spine & Joint PC CurrentSince Dec 15, 2025 Accepting new patients
Crafted Physical Therapy PLLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients
Montage Surgical Group Past Accepting new patients

Locations

12 Upper Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6060

21 Lower Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6040

701 Delaware Ave
Unit E
Longmont, CO 80501
Phone (303) 729-1447

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1023849759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DELAWARE AVE UNIT E",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016498",
            "telephone_number": "720-204-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELAWARE AVE UNIT E",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016498",
            "telephone_number": "720-204-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPIEC",
        "first_name": "JONATHAN",
        "middle_name": "WALTER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0020057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.