Individual provider Active NPI

Jessica Czarnecki, DPT

  • Physical Therapist
  • Highlands Ranch, CO
National Provider Identifier
1295352136
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0020070 Issued in CO
Practice address
8925 Ridgeline Blvd Ste 102
Highlands Ranch, CO 80129-2354
Phone
(720) 316-9974
Fax
(720) 294-0332
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 PTL.0020070 CO Primary

Addresses

Primary practice location

8925 Ridgeline Blvd Ste 102
Highlands Ranch, CO 80129-2354

Mailing address

PO Box 21150
Boulder, CO 80308-4150
Phone (720) 316-9974

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002004126 CO Practitioner - Physical Therapist in Private Practice 1456775915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Washington University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physioroom, LLCGroup PAC ID 0941552863, 13 clinicians

Practice addresses (Care Compare)

8925 Ridgeline Blvd
Suite 102
Highlands Ranch, CO 80129-2354
Phone (720) 560-5326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0020070COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Physical Therapy, Inc. Physical Therapist CurrentSince Oct 20, 2020 Accepting new patients
The Physioroom, LLC Current Accepting new patients
The Physioroom, LLC CurrentSince Aug 28, 2024 Accepting new patients
The Physioroom, LLC Physical Therapist CurrentSince Aug 28, 2024 Accepting new patients
Loon State Physical Therapy PastSince Nov 1, 2023 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist PastSince Jun 1, 2020 Accepting new patients
Apex Physical Therapy LLC PastSince Jun 1, 2020 Accepting new patients

Locations

2668 E Citizens Dr
Ste 5
Fayetteville, AR 72703
Phone (479) 442-7473

3484 W Wedington Dr
Ste 4
Fayetteville, AR 72704
Phone (479) 239-5432

8925 Ridgeline Blvd
Ste 102
Highlands Ranch, CO 80129
Phone (720) 316-9974

Organizations & group practices 7

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1295352136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21150",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803084150",
            "telephone_number": "720-316-9974",
            "fax_number": "720-294-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 RIDGELINE BLVD STE 102",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292354",
            "telephone_number": "720-316-9974",
            "fax_number": "720-294-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNECKI",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0020070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.