Individual provider Active NPI

Katarzyna Justyna Zazel-Wolska, PT

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1124741681
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-32551 Issued in AZ
Practice address
1729 E Hampton LN
Gilbert, AZ 85295-6060
Phone
(224) 715-2344
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 LPT-32551 AZ Primary

Addresses

Primary practice location

1729 E Hampton LN
Gilbert, AZ 85295-6060

Mailing address

1729 E Hampton LN
Gilbert, AZ 85295-6060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222002725 AZ Practitioner - Physical Therapist in Private Practice 0840660478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petkov Bodywork Therapy LLCGroup PAC ID 8820428444, 13 clinicians

Practice addresses (Care Compare)

5168 W Augusta Ave
Glendale, AZ 85301-1469
Phone (651) 442-5094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-32551AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Petkov Bodywork Therapy, LLC CurrentSince Sep 6, 2022 Accepting new patients
Allone Healthcare LLC CurrentSince Oct 27, 2024 Accepting new patients

Organizations & group practices 2

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1124741681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 E HAMPTON LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 E HAMPTON LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956060",
            "telephone_number": "224-715-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAZEL-WOLSKA",
        "first_name": "KATARZYNA",
        "middle_name": "JUSTYNA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.