Individual provider Active NPI

Damon J Kozicki, PT

  • Physical Therapist
  • Stevens Point, WI
National Provider Identifier
1508984055
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4791 Issued in WI
Practice address
3217 John Joanis Drive Suite D
Stevens Point, WI 54481
Phone
(715) 254-3978
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

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 4791 WI Primary

Addresses

Primary practice location

3217 John Joanis Drive Suite D
Stevens Point, WI 54481

Mailing address

3217 John Joanis Dr Ste D
Stevens Point, WI 54481-8852
Phone (715) 254-3978

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090130000238 WI Practitioner - Physical Therapist in Private Practice 5294899621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Point Forward Physical Therapy LTDGroup PAC ID 5890886550, 4 clinicians

Practice addresses (Care Compare)

2901 Hoover Rd
Stevens Point, WI 54481-5608
Phone (715) 254-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4791WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Point Forward Physical Therapy LTD. Physical Therapist CurrentSince Jan 27, 2009 Accepting new patients
Onpoint Performance LLC Physical Therapist PastSince May 11, 2025 Accepting new patients

Locations

3217 John Joanis Dr
Ste D
Stevens Point, WI 54482
Phone (715) 254-3978

2901 Hoover Rd
Stevens Point, WI 54481
Phone (715) 254-3978

Organizations & group practices 2

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234483200000",
    "number": "1508984055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 JOHN JOANIS DR STE D",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544818852",
            "telephone_number": "715-254-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 JOHN JOANIS DRIVE SUITE D",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-254-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZICKI",
        "first_name": "DAMON",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2009-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; 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.