Individual provider Active NPI

David Krawczyk, PT, DPT

  • Physical Therapist
  • Davenport, FL
National Provider Identifier
1689611253
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20492 Issued in FL
Practice address
104 Park Place Blvd Ste B
Davenport, FL 33837-6866
Phone
(863) 547-9793
Fax
(863) 547-9794
NPI assigned
Jun 1, 2006
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 PT20492 FL Primary

Addresses

Primary practice location

104 Park Place Blvd Ste B
Davenport, FL 33837-6866

Mailing address

345 W Michigan St
Suite 108
Orlando, FL 32806-4465
Phone (407) 888-2255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000026 FL Practitioner - Physical Therapist in Private Practice 4385673334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Specialists of Hunters Creek LLCGroup PAC ID 1355576745, 6 clinicians

Practice addresses (Care Compare)

104 Park Place Blvd
Suite B
Davenport, FL 33837-6866
Phone (863) 547-9793

104 Park Place Blvd B
Davenport, FL 33837-6866

14115 Town Loop Blvd
Suite 200
Orlando, FL 32837-4839
Phone (407) 601-3922

5200 Davisson Ave
Suite B
Orlando, FL 32810-5350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20492FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists of Pine Castle LLC Physical Therapist CurrentSince Mar 3, 2005 Accepting new patients
Physical Therapy Specialists of Hunters Creek, LLC Physical Therapist CurrentSince May 1, 2014 Accepting new patients

Locations

104 Park Place Blvd
Ste B
Davenport, FL 33837
Phone (863) 547-9793

14115 Town Loop Blvd
Ste 200
Orlando, FL 32837
Phone (407) 601-3922

345 W Michigan St
Ste 108
Orlando, FL 32806
Phone (407) 745-4633

7300 Sandlake Commons Blvd
Ste 305
Orlando, FL 32819
Phone (407) 802-4514

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1689611253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W MICHIGAN ST",
            "address_2": "SUITE 108",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064465",
            "telephone_number": "407-888-2255",
            "fax_number": "407-888-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PARK PLACE BLVD STE B",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376866",
            "telephone_number": "863-547-9793",
            "fax_number": "863-547-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAWCZYK",
        "first_name": "DAVID",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.