Individual provider Active NPI

John J Lewczyk, PT

  • Physical Therapist
  • Worcester, MA
National Provider Identifier
1700865672
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7090 Issued in MA
Practice address
112 Harding St
Worcester, MA 01604-5020
Phone
(508) 964-5592
Fax
(508) 453-8185
NPI assigned
Jan 10, 2006
Last updated
Nov 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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 7090 MA Primary

Addresses

Primary practice location

112 Harding St
Worcester, MA 01604-5020

Mailing address

5 Neponset St FL ST2
Worcester, MA 01606-2714
Phone (508) 856-9510

Other identifiers 19

IdentifierTypeStateIssuer
2779432OtherCIGNA HEALTH PLAN
43207OtherFALLON COMMUNITY HEALTH
Y67941OtherBLUE SHIELD HMO BLUE
56640OtherCHILDRENS MEDICAL SECURIT
650017412OtherRAILROAD MEDICARE
Y68466OtherMEDICARE B
0318949OtherMEDICAID WELFARE
Y67941OtherBLUE SHIELD INDEMNITY
042472266OtherPRIVATE HEALTHCARE SYSTEM
2779432001OtherCIGNA PAL ID
785957OtherMVP HEALTH CARE
0318949MedicaidMA
042472266OtherHEALTHCARE VALUE MANAGEME
042472266OtherONE HEALTH PLAN
042472266OtherTHREE RIVERS
35481155OtherCIGNA HEALTHSOURCE
7199625OtherAETNA US HEALTHCARE
AA4052OtherHARVARD PILGRIM HEALTHCAR
Y67941OtherBLUE CARE ELECT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061213000017 MA Practitioner - Physical Therapist in Private Practice 4981603370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

112 Harding St
Worcester, MA 01604-5466
Phone (508) 964-5592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7090MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Physical Therapist CurrentSince Oct 28, 1996 Accepting new patients
Reliant Medical Group, Inc CurrentSince Oct 28, 1996 Accepting new patients

Locations

112 Harding St
Worcester, MA 01604
Phone (508) 964-5592

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl ST2
Worcester, MA 01606

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

  • Direct secure messaging: john.lewczyk.npi1700865672.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1700865672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL ST2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HARDING ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016045020",
            "telephone_number": "508-964-5592",
            "fax_number": "508-453-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWCZYK",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "7090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "2779432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH",
            "identifier": "43207",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "Y67941",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "56640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650017412",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "Y68466",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELFARE",
            "identifier": "0318949",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "Y67941",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL ID",
            "identifier": "2779432001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "785957",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0318949",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MANAGEME",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "35481155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7199625",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA4052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "Y67941",
            "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 Nov 30, 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.