Individual provider Active NPI

Kaitlynn Marie Vacchio, PT, DPT, CSCS

  • Physical Therapist
  • Wyomissing, PA
National Provider Identifier
1457726226
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT028999 Issued in PA
Practice address
1405A Penn Ave
Wyomissing, PA 19610-2133
Phone
(610) 396-9278
Fax
(610) 396-9242
NPI assigned
Dec 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305212584 VA
Physical Therapist 225100000X PT028999 PA Primary
Physical Therapist 225100000X 039705-1 NY

Addresses

Primary practice location

1405A Penn Ave
Wyomissing, PA 19610-2133

Mailing address

224 Strawbridge Dr Ste 100
Moorestown, NJ 08057-4602
Phone (856) 677-4000

Other names 1

  • Ms. Kairlynn Marie Trzaska Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220519000906 PA Practitioner - Physical Therapist in Private Practice 1355643925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Strive Physical Therapy Specialists LLCGroup PAC ID 6709292535, 163 clinicians

Practice addresses (Care Compare)

1405 Penn Ave
Suite a
Wyomissing, PA 19610-2154
Phone (610) 396-9278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039705-1NYMDGeriatric Pharmacist
PT028999PAMDPhysical Therapist
2305212584VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Physical Therapy Specialists LLC CurrentSince May 12, 2022 Accepting new patients
Strive Physical Therapy Specialists LLC Physical Therapist CurrentSince May 12, 2022 Accepting new patients
Western Berks Physical Therapy Inc. Physical Therapist CurrentSince May 16, 2022 Accepting new patients
Strive Physical Therapy Specialists LLC Physical Therapist Past Accepting new patients

Locations

224 Strawbridge Dr
Ste 100
Moorestown, NJ 08057
Phone (856) 677-4000

5479 Pottsville Pike
Ste 200
Leesport, PA 19533
Phone (610) 926-6778

2 Penn Ctr
Ste 450
Philadelphia, PA 19102
Phone (215) 454-2812

1405 Penn Ave
Ste A
Wyomissing, PA 19610
Phone (610) 396-9278

1405 Penn Ave
#A
Wyomissing, PA 19610
Phone (610) 396-9278

Organizations & group practices 4

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": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1457726226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 STRAWBRIDGE DR STE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574602",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405A PENN AVE",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102133",
            "telephone_number": "610-396-9278",
            "fax_number": "610-396-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCHIO",
        "first_name": "KAITLYNN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212584",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028999",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039705-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAIRLYNN",
            "last_name": "TRZASKA",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PT, DPT, CSCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.