John Kielbasa
Individual provider Active NPI Physical Therapist · Montrose, PA
NPI 1487375846 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1487375846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT031336 (PA)
- Practice address
- 417 Grow Ave
Montrose, PA 18801-1105 - Phone
- (570) 278-1101
- Fax
- (570) 278-1102
- NPI assigned
- Sep 6, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- LHMG Physical Therapy, LLC
Practice addresses (Care Compare)
1153 State Route 3 N
Suite 35
Gambrills, MD 21054-1737
Phone 4102162200443292
1332 Cape St Claire Rd
Annapolis, MD 21409-5216
Phone (443) 481-1140
6836 Race Track Rd
Bowie, MD 20715-3011
Phone (301) 805-7004
7611 Crain Hwy
C 170
Upper Marlboro, MD 20772-4258
Phone (443) 481-1140
8109 Ritchie Hwy
Suite 600
Pasadena, MD 21122-6905
Phone (410) 553-3515
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in DC, MD, PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221006001946 | DC | Practitioner - Physical Therapist in Private Practice | 3779969258 | Reassigns benefits to 2 organizations |
| I20221129000874 | MD | Practitioner - Physical Therapist in Private Practice | 3779969258 | Reassigns benefits to 3 organizations |
| I20231107002006 | PA | Practitioner - Physical Therapist in Private Practice | 3779969258 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT031336 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pivot Physical Therapy of Pennsylvania, LLC | Physical Therapist | Current |
Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current |
Accepting new patients |
| LHMG Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current |
Accepting new patients |
| LHMG Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| LHMG Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| LHMG Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Dynamic Therapy Services, LLC | Physical Therapist | Past | Accepting new patients |
| Procare Physical Therapy Inc | Physical Therapist | Past |
Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190
6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004
15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190
4740 Cherry Hill Rd
College Park, MD 20740
Phone (240) 965-0999
28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270
1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619
212 Rosewick Rd
La Plata, MD 20646
Phone (240) 776-6900
8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508
18302 Contour Rd
Montgomery Village, MD 20877
Phone (240) 912-2060
8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515
52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100
11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280
350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919
417 Grow Ave
Montrose, PA 18801
Phone (570) 278-1101
655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142
130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 29093 | MD | |
| Physical Therapist | 225100000X | PT031336 | PA | Yes |
Addresses
Primary practice location
417 Grow Ave
Montrose, PA 18801-1105
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other practice location 1
4740 Cherry Hill Rd
College Park, MD 20740-1330
Phone (240) 965-0999
Other providers in Montrose, PA
- Brittany L Johnson
- Jonathan Jorda
- Stuart Kaufman
- Heather Lynn Kesler
- Hassan Y Khalil
- Abigail Klase
- Katie Michele Kronyak
- Kenneth R Lattimore
- Cheryl Leonard
- Ann Lewis
All providers in Montrose, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.