Individual provider Active NPI

Jessica Wojtysiak, RPT

  • Physical Therapist
  • Duluth, MN
National Provider Identifier
1508099979
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11331-024 Issued in WI
Practice address
915 E 1St St
Duluth, MN 55805-2107
Phone
(715) 395-3970
NPI assigned
Sep 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11331-024 WI Primary

Addresses

Primary practice location

915 E 1St St
Duluth, MN 55805-2107

Mailing address

915 E 1St St
Duluth, MN 55805-2107
Phone (715) 395-3970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308001045 MN Practitioner - Physical Therapist in Private Practice 2264614510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11331-024WIMDPhysical Therapist

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": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1508099979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "715-395-3970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052107",
            "telephone_number": "715-395-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJTYSIAK",
        "first_name": "JESSICA",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11331-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.