Active NPI
Kent P Jaskoviak, PT
- Physical Therapist
- Worcester, MA
National Provider Identifier
1689652703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13115
- Practice address
- 135 Gold Star Blvd
Worcester, MA 01606 - Phone
- (508) 856-9510
- Fax
- (508) 853-1907
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13115 | MA | Primary |
Addresses
Primary practice location
135 Gold Star Blvd
Worcester, MA 01606
Mailing address
630 Plantation St
Wot 12TH Floor Attn: Physician Services
Worcester, MA 01605
Phone (508) 368-5529
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7248629 | Other | AETNA US HEALTHCARE | |
| Y68470 | Other | MEDICARE B | |
| 2779432 | Other | CIGNA HEALTH PLAN | |
| Y67947 | Other | BLUE SHIELD HMO BLUE | |
| 0318922 | Other | MEDICAID WELFARE | |
| 0318922 | Medicaid | MA | |
| 2779432001 | Other | CIGNA PAL ID | |
| AA4052 | Other | HARVARD PILGRIM HEALTHCAR | |
| 35481155 | Other | CIGNA HEALTHSOURCE | |
| 43205 | Other | FALLON COMMUNITY HEALTH P | |
| Y67947 | Other | BLUE CARE ELECT | |
| Y67947 | Other | BLUE SHIELD INDEMNITY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Worcester, MA
- NPI 1720017528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1689652703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"address_2": "WOT 12TH FLOOR ATTN: PHYSICIAN SERVICES",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-368-5529",
"fax_number": "508-368-5530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 GOLD STAR BLVD",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01606",
"telephone_number": "508-856-9510",
"fax_number": "508-853-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASKOVIAK",
"first_name": "KENT",
"middle_name": "P",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "13115",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "7248629",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B",
"identifier": "Y68470",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLAN",
"identifier": "2779432",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HMO BLUE",
"identifier": "Y67947",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID WELFARE",
"identifier": "0318922",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0318922",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PAL ID",
"identifier": "2779432001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTHCAR",
"identifier": "AA4052",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHSOURCE",
"identifier": "35481155",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "43205",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE ELECT",
"identifier": "Y67947",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "Y67947",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.