Jaymes Joseph William Sajczuk, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7001 Issued in ID

Practice address

678 Southway Ave
Lewiston, ID 83501-3783

Phone

(208) 746-1418

Fax

(208) 746-4123

NPI assigned

May 26, 2020

Last updated

May 26, 2020By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peak Physical Therapy P C

  • Physical Therapist
  • Boise, ID
  • NPI 1073551560
  Medicare reassignment NPD

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1336762343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 SOUTHWAY AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013783",
            "telephone_number": "208-746-1418",
            "fax_number": "208-746-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 SOUTHWAY AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013783",
            "telephone_number": "208-746-1418",
            "fax_number": "208-746-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAJCZUK",
        "first_name": "JAYMES",
        "middle_name": "JOSEPH WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT-7001",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Russell, PHARMD
• S.P.O.R.T. Physical Therapy Clinic
• S.P.O.R.T. Physical Therapy Clinic
• S.P.O.R.T. Physical Therapy Clinic
• Kelsey Sadowski
• Kristien Ann Sal Dana, LCSW
• Elizabeth Samson
• Mallory Lee Satter
• Liliana C Saunero-Nava, M.D.
• Casey Lee Sayre, PHARMD

• Physical Therapist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.