Tesse Lane Maciejko, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0016628 Issued in CO

Practice address

611 E Star CT
Suite B
Montrose, CO 81401-6704

Phone

(970) 249-1646

Fax

(970) 249-8899

NPI assigned

Sep 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, VI, ME3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saco Bay Orthopaedic and Sports Physical Therapy IncGroup PAC ID 9537069265, 137 clinicians

Cog Restore, LLCGroup PAC ID 1557665502, 10 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Cog Restore, LLC

  • Rehabilitation Clinic/Center
  • St Thomas, VI
  • NPI 1194108761

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Saco Bay Orthopaedic and Sports Physical Therapy, Inc

  • Physical Therapist
  • Saco, ME
  • NPI 1346254315
  Medicare reassignment Care Compare group
• In Motion Hand Therapy Inc

  • Rehabilitation Clinic/Center
  • Montrose, CO
  • NPI 1407804065

  Physical Therapist

  NPD
• Montrose Memorial Hospital, Inc

  • Diagnostic Radiology Physician
  • Montrose, CO
  • NPI 1437997947
  NPD (past)

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1366092272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E STAR CT STE B",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016704",
            "telephone_number": "970-249-1646",
            "fax_number": "970-249-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E STAR CT",
            "address_2": "SUITE B",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814016704",
            "telephone_number": "970-249-1646",
            "fax_number": "970-249-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9053 Estate Thomas Suite 206",
            "address_purpose": "LOCATION",
            "city": "St. Thomas",
            "state": "VI",
            "postal_code": "00802",
            "country_code": "US",
            "telephone_number": "340-779-9355",
            "fax_number": "340-779-9350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 Dalton Street",
            "address_purpose": "LOCATION",
            "city": "Haines",
            "state": "AK",
            "postal_code": "99827",
            "country_code": "US",
            "telephone_number": "907-766-6390 x66027",
            "fax_number": "907-766-6305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 11th St N",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "MT",
            "postal_code": "590197215",
            "country_code": "US",
            "telephone_number": "406-322-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 N Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Red Lodge",
            "state": "MT",
            "postal_code": "590689222",
            "country_code": "US",
            "telephone_number": "406-446-2345",
            "fax_number": "406-446-0095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACIEJKO",
        "first_name": "TESSE",
        "middle_name": "LANE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7383",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016628",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "196622",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "21536",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VI",
            "license": "318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Lott, PHARMD
• Amy Irene Page Lowy, RD
• Loyal Mental Health
• Keith Lundberg, D.C.
• Martin S Lutz
• Jody Mack, PA
• Avery Mackenzie, M.D.
• Tara Madden, D.C.
• Douglas Maddy
• Jenina T Madrid, MS, NCC

• Physical Therapist in Montrose, CO
• Providers in Montrose, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.