Individual provider Active NPI

Kaycie Dziedzicki, PT, DPT

  • Orthopedic Physical Therapist
  • Tallahassee, FL
National Provider Identifier
1417831306
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT41755 Issued in FL
Practice address
2615 Centennial Blvd Ste 101
Tallahassee, FL 32308-0589
Phone
(850) 656-1837
NPI assigned
Aug 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT41755 FL Primary

Addresses

Primary practice location

2615 Centennial Blvd Ste 101
Tallahassee, FL 32308-0589

Mailing address

2615 Centennial Blvd Ste 101
Tallahassee, FL 32308-0589
Phone (850) 656-1837

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903000327 FL Practitioner - Physical Therapist in Private Practice 9537660279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopedic and Sports Physical Therapy P aGroup PAC ID 7810069127, 24 clinicians

Practice addresses (Care Compare)

2615 Centennial Blvd
Suite 101
Tallahasse, FL 32308-0589
Phone (850) 656-1837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic and Sports Physical Therapy P a Orthopedic CurrentSince Aug 11, 2025 Accepting new patients

Locations

2615 Centennial Blvd
Ste 101
Tallahassee, FL 32308

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1417831306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CENTENNIAL BLVD STE 101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080589",
            "telephone_number": "850-656-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CENTENNIAL BLVD STE 101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080589",
            "telephone_number": "850-656-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIEDZICKI",
        "first_name": "KAYCIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT41755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.