Individual provider Active NPI

Jessica Anne Hartzell, MSPT

  • Physical Therapist
  • Durham, NC
National Provider Identifier
1093838328
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6836 Issued in NC
Practice address
40 Duke Medicine Cir
Department of Rehabiliation Services
Durham, NC 27710-4000
Phone
(919) 684-2088
Fax
(919) 668-3131
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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 6836 NC Primary

Addresses

Primary practice location

40 Duke Medicine Cir
Department of Rehabiliation Services
Durham, NC 27710-4000

Mailing address

40 Duke Medicine Clinic- Dept of Rehabilitation Service
Box 3965
Raleigh, NC 27710
Phone (919) 684-2088

Other identifiers 1

IdentifierTypeStateIssuer
1108GOtherNCBCBS

Other names 1

  • Jessica A Kostyu Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000636 NC Practitioner - Physical Therapist in Private Practice 6406861079 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6836NCMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. Physical Therapist CurrentSince Feb 26, 2019 Accepting new patients
Duke University Health System, Inc. CurrentSince Feb 26, 2019 Accepting new patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients
Breakthrough Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

501 Douglas St
Durham, NC 27705
Phone (800) 235-3853

1821 Hillandale Rd
Ste 25B
Durham, NC 27705
Phone (919) 613-9105

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1093838328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CLINIC- DEPT OF REHABILITATION SERVICE",
            "address_2": "BOX 3965",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27710",
            "telephone_number": "919-684-2088",
            "fax_number": "919-668-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CIR",
            "address_2": "DEPARTMENT OF REHABILIATION SERVICES",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277104000",
            "telephone_number": "919-684-2088",
            "fax_number": "919-668-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZELL",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1108G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KOSTYU",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.

Verify at the official NPI Registry.