Active NPI
Kimberly Sawczyn, PT
- Specialist
- Montclair, NJ
National Provider Identifier
1033155254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 40QA00990100
- Practice address
- 1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3649 - Phone
- (973) 746-2424
- Fax
- (973) 746-5030
- NPI assigned
- Jun 22, 2006
- Last updated
- Sep 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 40QA00990100 | NJ | Primary |
Addresses
Primary practice location
1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3649
Mailing address
644 Valley Rd
Gillette, NJ 07933-2012
Phone (908) 991-3761
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00990100 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Physical Therapy LLC | Current | Accepting new patients | |
| Ignite Rehab Corp | Current | Accepting new patients | |
| New Jersey Spine & Sports Medicine, P.C. | Specialist | Past | Accepting new patients |
| MCRC Physical Therapy, LLC | Past | Accepting new patients | |
| United Sports Care & Physical Therapy | Past | Accepting new patients |
Locations
1003 Main Ave
Clifton, NJ 07011
Phone (201) 344-2499
800 E Gate Blvd
Garden City, NY 11530
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630886400000",
"number": "1033155254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "644 VALLEY RD",
"city": "GILLETTE",
"state": "NJ",
"postal_code": "079332012",
"telephone_number": "908-991-3761",
"fax_number": "908-991-3770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GREENWOOD AVE",
"address_2": "SUITE 100",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423649",
"telephone_number": "973-746-2424",
"fax_number": "973-746-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAWCZYN",
"first_name": "KIMBERLY",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2021-09-06",
"certification_date": "2021-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "40QA00990100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2021; 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.