Jacek Marian Wiczynski, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

012200-1 Issued in NY

Practice address

161 Cedar LN
Babylon, NY 11702-4318

Phone

(631) 650-1849

NPI assigned

May 4, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

State University of New York at Stony Brook, School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Energize Home Physical Therapy PLLCGroup PAC ID 8426319161, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Energize Home Physical Therapy PLLC

  • Physical Therapist
  • Saint James, NY
  • NPI 1356849491
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1209859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1477729010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 CEDAR LN",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117024318",
            "telephone_number": "516-607-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CEDAR LN",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117024318",
            "telephone_number": "631-650-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICZYNSKI",
        "first_name": "JACEK",
        "middle_name": "MARIAN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-04",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012200-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Weisbecker, RN
• Matthew Scott Weitzman, M.S., L.AC.
• Well Within Nutrition
• West Islip PT & Chiropractic PLLC (West Islip PTDC)
• Aleksandra A Wianecka, O.D.
• Catherine Anne Wieland, NP
• Marjorie Wills, RN
• Matthew Todd Winokur, DC
• Cheri Kay Winter, PT
• Carlton Witherspoon, LPN

• Occupational Therapist in Babylon, NY
• Providers in Babylon, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.