Jacob Mark Januszewski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8522 Issued in MN

Practice address

301 N Broadway
Pelican Rapids, MN 56572-4113

Phone

(218) 863-2000

NPI assigned

Nov 2, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Enrollment records 2

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.

• St. Marys Regional Health Center

  dba Essentia Health St. Mary's- Detroit Lakes

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Medicare reassignment NPD
• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• St Mary's Regional Health Center

  dba Essentia Health St. Mary's-Frazee Clinic

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482
  NPD
• St. Mary's Regional Health Center

  dba Essentia Health St. Mary's - Mahnomen Clinic

  • Rural Health Clinic/Center
  • Mahnomen, MN
  • NPI 1750725586
  NPD
• Innovis Health LLC

  dba Essentia Health-Osgood Clinic

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1144776576
  NPD
• Innovis Health, LLC.

  dba Essentia Health Wahpeton Clinic

  • Family Medicine Physician
  • Wahpeton, ND
  • NPI 1790965440
  NPD

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1366728412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N BROADWAY",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565724113",
            "telephone_number": "218-863-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N BROADWAY",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565724113",
            "telephone_number": "218-863-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 11th St S",
            "address_purpose": "LOCATION",
            "city": "Wahpeton",
            "state": "ND",
            "postal_code": "580754655",
            "country_code": "US",
            "telephone_number": "701-642-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANUSZEWSKI",
        "first_name": "JACOB",
        "middle_name": "MARK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-02",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1570",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366728412",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raina Heruth
• Amanda Carol Houghtaling, FNP
• Hovland Healthcare Products, LLC
• Torrey Lee Hovland, OTR/L
• Ind School Dist 548
• Shayla Marie Jegtvig, NURSE PRACTITIONER
• Emily Kalina, NP
• Danelle H Kosciarz, OTR/L
• Lakeland Smiles, PLLC
• Peter Larson

• Physical Therapist in Pelican Rapids, MN
• Providers in Pelican Rapids, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.