Kyle David Kowalczyk, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501302651 Issued in MI

Practice address

400 Rounds Dr
Fenton, MI 48430-1724

Phone

(810) 750-1996

Fax

(810) 750-6361

NPI assigned

Oct 4, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plymouth Physical Therapy Specialists Limited PartnershipGroup PAC ID 3870488521, 65 clinicians

Ivyrehab Michigan LLCGroup PAC ID 6901165893, 156 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Northville, MI
  • NPI 1174626329
  Medicare reassignment Care Compare group
• Plymouth Physical Therapy Specialists Limited Partnership

  • Physical Therapist
  • Livonia, MI
  • NPI 1689691388
  NPD (past)

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1114707312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412031",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412031",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ROUNDS DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301724",
            "telephone_number": "810-750-1996",
            "fax_number": "810-750-6361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 W Main St Ste 120",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481671548",
            "country_code": "US",
            "telephone_number": "248-347-1168",
            "fax_number": "248-347-1252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-04",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501302651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Elizabeth Kirkpatrick, DDS
• Lisa Klammer, MA, LLPC, NCC
• Ashley Nichole Kochan
• Anna Leigh Koontz, OTRL
• Richard Arthur Kopek
• Tamara Kreifeldt
• Kroger Co of Michigan
• Leslie Ann Krol, MA, LPC
• Tamara Lynn Kulchar
• Kurtis Lahring, LMSW-C

• Physical Therapist in Fenton, MI
• Providers in Fenton, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.