Individual provider Active NPI

Alex John Krywoschyj, OTR/L

  • Occupational Therapist
  • Jamestown, NY
National Provider Identifier
1689019762
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
021396-1 Issued in NY
Practice address
75 Jones and Gifford Ave
Jamestown, NY 14701-2828
Phone
(716) 661-4836
NPI assigned
May 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC012722 PA
Occupational Therapist 225X00000X 021396-1 NY Primary

Addresses

Primary practice location

75 Jones and Gifford Ave
Jamestown, NY 14701-2828

Mailing address

200 Dunham Ave
Jamestown, NY 14701-2528
Phone (716) 661-1541

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608000440 NY Practitioner - Occupational Therapist in Private Practice 1153621651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021396-1NYMDOccupational Therapist
OC012722PAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua Co. Chapter of Nysarc Inc Dba the Resource Center Current Accepting new patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Apr 29, 2017 Accepting new patients
Chautauqua County Chapter of Nysarc Inc CurrentSince Apr 29, 2017 Accepting new patients

Locations

200 Dunham Ave
Jamestown, NY 14701
Phone (716) 661-1400

890 E 2nd St
Jamestown, NY 14701
Phone (716) 661-1447

Interoperability endpoints

  • Direct secure messaging: alex.krywoschyj@resourcecenter.cernerdirect.com

Organizations & group practices 3

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689019762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DUNHAM AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012528",
            "telephone_number": "716-661-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JONES AND GIFFORD AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012828",
            "telephone_number": "716-661-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYWOSCHYJ",
        "first_name": "ALEX",
        "middle_name": "JOHN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC012722",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "021396-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • 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.
  • 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.