Individual provider Active NPI

Jessica Marie Zielecki, PT, DPT

  • Physical Therapist
  • Williamsport, PA
National Provider Identifier
1114406394
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT025960 Issued in PA
Practice address
625 W Edwin St
Williamsport, PA 17701-4909
Phone
(570) 326-0565
NPI assigned
Aug 9, 2018
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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 PT025960 PA Primary

Addresses

Primary practice location

625 W Edwin St
Williamsport, PA 17701-4909

Mailing address

81 Campbell Rd
Benton, PA 17814-7729
Phone (570) 854-0223

Other practice location 1

1133 Wyoming Ave
Kingston, PA 18704-4003
Phone (570) 714-1246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250505001861 PA Practitioner - Physical Therapist in Private Practice 6204353105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007573LPAMDPhysical Therapist
PT025960PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyoming Valley Childrens Association Physical Therapist CurrentSince Mar 29, 2025 Accepting new patients
Lycoming County Crippled Children's Physical Therapist Past Accepting new patients
Upmc Williamsport Past Accepting new patients

Locations

1133 Wyoming Ave
Kingston, PA 18704
Phone (570) 714-1246

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1114406394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 CAMPBELL RD",
            "city": "BENTON",
            "state": "PA",
            "postal_code": "178147729",
            "telephone_number": "570-854-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W EDWIN ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177014909",
            "telephone_number": "570-326-0565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1133 Wyoming Ave",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "PA",
            "postal_code": "187044003",
            "country_code": "US",
            "telephone_number": "570-714-1246",
            "fax_number": "570-714-1249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIELECKI",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.