Active NPI
Kyle C Kaszynski, PT
- Physical Therapist
- Germantown, WI
National Provider Identifier
1417932096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11665
- Practice address
- N112W17975 Mequon Rd
Germantown, WI 53022-2425 - Phone
- (262) 532-7600
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 070-012054 | IL | |
| Physical Therapist | 225100000X | 11665 | WI | Primary |
Addresses
Primary practice location
N112W17975 Mequon Rd
Germantown, WI 53022-2425
Mailing address
3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 389-2233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100024669 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kkaszynski15502@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11665 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 070-012054 | IL | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elmhurst Orthopaedics, SC | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- Elmhurst, IL
- NPI 1598716474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1417932096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 W FOREST HOME AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532152843",
"telephone_number": "414-389-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N112W17975 MEQUON RD",
"city": "GERMANTOWN",
"state": "WI",
"postal_code": "530222425",
"telephone_number": "262-532-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASZYNSKI",
"first_name": "KYLE",
"middle_name": "C",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IL",
"license": "070-012054",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11665",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100024669",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kkaszynski15502@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "N112W17975 Mequon Rd",
"city": "Germantown",
"state": "WI",
"country_code": "US",
"postal_code": "530222425",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "N112W17975 Mequon Rd",
"city": "Germantown",
"state": "WI",
"country_code": "US",
"postal_code": "530222425",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Germantown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.