Individual provider Active NPI

Kaitlyn Jesionowski, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1346124732
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-3431
NPI assigned
Jul 31, 2025
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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 NU Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

5700 Williamsburg Landing Dr
Williamsburg, VA 23185-3779
Phone (800) 554-5517

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250925003529 VA Practitioner - Physical Therapist in Private Practice 6901301365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, shared by 5 NPIs, 201 clinicians

Practice addresses (Care Compare)

1092 Lexington St
Waltham, MA 02452-7206
Phone (781) 906-8442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist CurrentSince Aug 6, 2025 Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

13030 Warwick Blvd
Newport News, VA 23602
Phone (757) 223-1668

1410 N Augusta St
#A
Staunton, VA 24401

3317 Ocean Shore Ave
Virginia Beach, VA 23451
Phone (757) 232-3179

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1346124732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 WILLIAMSBURG LANDING DR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853779",
            "telephone_number": "800-554-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESIONOWSKI",
        "first_name": "KAITLYN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-07-31",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.