Jacob John Kmiecik, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60852959 Issued in WA

Practice address

1218 3Rd Ave Ste 104
Seattle, WA 98101-3008

Phone

(206) 447-2220

Fax

(206) 447-2228

NPI assigned

Aug 15, 2018

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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Creighton University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerald City Physical Therapy SVCS LLCGroup PAC ID 0547442469, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Emerald City Physical Therapy SVCS, LLC

  • Physical Medicine & Rehabilitation Physician
  • Seattle, WA
  • NPI 1881998482
  Medicare reassignment Care Compare group NPD
• Core Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Seattle, WA
  • NPI 1356411011
  Medicare reassignment NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1497731244
  Medicare reassignment NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Selah, WA
  • NPI 1629304746
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1578043089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 LEARY AVE NW APT 643",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074081",
            "telephone_number": "402-350-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 3RD AVE STE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013008",
            "telephone_number": "206-447-2220",
            "fax_number": "206-447-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KMIECIK",
        "first_name": "JACOB",
        "middle_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60852959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Lynne Kloster, RPH
• Cherise Maleyna Klotz, M.S.
• Barbara S Klube, CRNA
• Gracie Klumpp
• Danielle Yvonne Kluz, LMT
• Tracey Kmiecik, MPH, RD
• Kristen Knapick, LMHC
• Calvin H Knapp Jr., MD
• Christopher James Knapp
• Hannah May Knapp, LMHC

• Physical Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.