Individual provider Active NPI

Jaclyn Olszewski, PT

  • Physical Therapist
  • Wilkes Barre, PA
National Provider Identifier
1588511562
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006237L Issued in PA
Practice address
1122 Highway 315 Blvd
Wilkes Barre, PA 18702-6943
Phone
(877) 407-3422
NPI assigned
Mar 11, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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 PT006237L PA Primary

Addresses

Primary practice location

1122 Highway 315 Blvd
Wilkes Barre, PA 18702-6943

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

Other names 1

  • Jaclyn Lisman Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260323003473 PA Practitioner - Physical Therapist in Private Practice 2062996556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

10475 Perry Hwy
Suite 106G
Wexford, PA 15090-9213
Phone (877) 407-4322

1122 Hwy 315 Blvd
Wilkes Barre, PA 18702-6943
Phone (877) 407-3422

470 N Lewis Rd
Bon Homie LTD Adult Day Center
Limerick, PA 19468-1511
Phone (610) 792-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT006237LPAMDPhysical 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": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1588511562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187026943",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSZEWSKI",
        "first_name": "JACLYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT006237L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "LISMAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.