Lucas Jay Wachewicz, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10424-24 Issued in WI

Practice address

1101 W Clairemont Ave
Eau Claire, WI 54701-4503

Phone

(715) 471-0954

Fax

(844) 829-7001

NPI assigned

Apr 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568637593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014503",
            "telephone_number": "715-471-0954",
            "fax_number": "844-829-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014503",
            "telephone_number": "715-471-0954",
            "fax_number": "844-829-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Knapp St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Rice Lake",
            "state": "WI",
            "postal_code": "548681381",
            "country_code": "US",
            "telephone_number": "715-736-4384",
            "fax_number": "844-829-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACHEWICZ",
        "first_name": "LUCAS",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10424-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568637593",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vop Eau Claire II LLC
• Vop Eau Claire II LLC
• Martin J Voss, MD
• Voyage Counseling
• Kelly L Wachewicz, PT
• John L Waciuma, M.D.
• John Wagenknecht Jr., LCSW
• Amanda Wagner
• Caitlin Marie Wagner
• Emily Wagner

• Physical Therapist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.