Individual provider Active NPI

John Roy Wawrzyniak, PT, ATC

  • Orthopedic Physical Therapist
  • Hershey, PA
National Provider Identifier
1164727459
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT008208L Issued in PA
Practice address
30 Hope Dr
Mail Code Ec 130
Hershey, PA 17033-2036
Phone
(717) 531-4003
Fax
(717) 531-4558
NPI assigned
Jan 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT008208L PA Primary

Addresses

Primary practice location

30 Hope Dr
Mail Code Ec 130
Hershey, PA 17033-2036

Mailing address

30 Hope Dr
P.O Box 859, Mail Code Ec 130
Hershey, PA 17033-2036
Phone (717) 531-4003

Other practice location 1

101 N College Ave
Annville, PA 17003-1404
Phone (717) 531-8070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823003581 PA Practitioner - Physical Therapist in Private Practice 8729350848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Aug 1, 2025 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 1, 2025 Accepting new patients

Locations

101 N College Ave
Annville, PA 17003
Phone (717) 531-8070

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

30 Hope Dr
Hershey, PA 17033
Phone (717) 531-3828

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

30 Hope Dr
#130
Hershey, PA 17033
Phone (717) 531-8070

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

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": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1164727459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HOPE DR",
            "address_2": "P.O BOX 859, MAIL CODE EC 130",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332036",
            "telephone_number": "717-531-4003",
            "fax_number": "717-531-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HOPE DR",
            "address_2": "MAIL CODE EC 130",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332036",
            "telephone_number": "717-531-4003",
            "fax_number": "717-531-4558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 N College Ave",
            "address_purpose": "LOCATION",
            "city": "Annville",
            "state": "PA",
            "postal_code": "170031404",
            "country_code": "US",
            "telephone_number": "717-531-8070",
            "fax_number": "717-531-0138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAWRZYNIAK",
        "first_name": "JOHN",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-18",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT008208L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

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