Individual provider Active NPI

Donna Elizabeth Wiejkus, PHYSICAL THERAPIST

  • Sports Physical Therapist
  • Brookline, MA
National Provider Identifier
1053464388
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
16320 Issued in MA
Practice address
33 Pond Ave
Suite 107B
Brookline, MA 02445-7163
Phone
(617) 232-7246
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 16320 MA Primary
Orthopedic Physical Therapist 2251X0800X 16320 MA

Addresses

Primary practice location

33 Pond Ave
Suite 107B
Brookline, MA 02445-7163

Mailing address

2001 Falls Blvd
Apt # 101
Quincy, MA 02169
Phone (617) 797-7930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16320MAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beantown Physio, Inc Sports PastSince Aug 2, 1999 Accepting new patients

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1053464388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 FALLS BLVD",
            "address_2": "APT # 101",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "617-797-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 POND AVE",
            "address_2": "SUITE 107B",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457163",
            "telephone_number": "617-232-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEJKUS",
        "first_name": "DONNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MA",
            "license": "16320",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "16320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.