James Ethan Maciejewski, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

10033 Wicker Ave Ste 7&8
Saint John, IN 46373-8776

Phone

(219) 213-2222

NPI assigned

Feb 12, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path

  • Physical Therapist
  • Peru, IN
  • NPI 1750764494
  Medicare reassignment NPD
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1215637699
  NPD

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1770347551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10562 MALOIAN DR",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739185",
            "telephone_number": "219-310-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10033 WICKER AVE STE 7&8",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738776",
            "telephone_number": "219-213-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEJEWSKI",
        "first_name": "JAMES",
        "middle_name": "ETHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie M Laporta, M.A., CCC-SLP
• Karen Lynn Lashure
• Kalli Letz
• Nanette Lindesmith, FNP
• Steven M Lubera, DO
• Nikhil Malik, P.T., C.E.A.S.
• Philip James Mangiaracina, DMD
• Ruba Mansour
• Dorothy Maria Mason, SLP
• Norbert A Matulis, DDS

• Physical Therapist in Saint John, IN
• Providers in Saint John, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.