John J Lewczyk, PT
Individual provider Active NPI Physical Therapist · Worcester, MA
NPI 1700865672 · NPPES record last updated Nov 30, 2018
Key facts
- NPI
- 1700865672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 7090 (MA)
- Practice address
- 112 Harding St
Worcester, MA 01604-5020 - Phone
- (508) 964-5592
- Fax
- (508) 453-8185
- NPI assigned
- Jan 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- 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 Inc
Practice addresses (Care Compare)
112 Harding St
Worcester, MA 01604-5466
Phone (508) 964-5592
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061213000017 | MA | Practitioner - Physical Therapist in Private Practice | 4981603370 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7090 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | Current |
Accepting new patients | |
| Reliant Medical Group, Inc | Physical Therapist | Current |
Accepting new patients |
Locations
112 Harding St
Worcester, MA 01604
Phone (508) 964-5592
5 Neponset St
Fl ST2
Worcester, MA 01606
135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400
5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300
630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529
Interoperability endpoints
- john.lewczyk.npi1700865672.reliant@direct.optumcare.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7090 | MA | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y67941 | Other | BLUE CARE ELECT | |
| 2779432 | Other | CIGNA HEALTH PLAN | |
| 650017412 | Other | RAILROAD MEDICARE | |
| Y67941 | Other | BLUE SHIELD HMO BLUE | |
| Y68466 | Other | MEDICARE B | |
| 042472266 | Other | ONE HEALTH PLAN | |
| 2779432001 | Other | CIGNA PAL ID | |
| 56640 | Other | CHILDRENS MEDICAL SECURIT | |
| 35481155 | Other | CIGNA HEALTHSOURCE | |
| 785957 | Other | MVP HEALTH CARE | |
| 43207 | Other | FALLON COMMUNITY HEALTH | |
| 0318949 | Other | MEDICAID WELFARE | |
| 0318949 | Medicaid | MA | |
| 042472266 | Other | HEALTHCARE VALUE MANAGEME | |
| 042472266 | Other | PRIVATE HEALTHCARE SYSTEM | |
| 7199625 | Other | AETNA US HEALTHCARE | |
| AA4052 | Other | HARVARD PILGRIM HEALTHCAR | |
| 042472266 | Other | THREE RIVERS | |
| Y67941 | Other | BLUE SHIELD INDEMNITY |
Other providers in Worcester, MA
- Keith C Levy
- Alyssa Lewandowski
- Jeffrey Lewandowski
- Laura Lewandowski
- Alexandra Marie Lewczyk
- George Lewinnek
- Catherine Lewis
- Jennifer Lewis
- Joanne M. Lewis
- Kacey Lynn Lewis
All providers in Worcester, MA · Physical Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.