Individual provider Active NPI

Janet Taylor Kowalchick, MPT

  • Orthopedic Physical Therapist
  • El Dorado Hills, CA
National Provider Identifier
1770542102
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
22102 Issued in CA
Practice address
991 Governor Drive
Suite 104
El Dorado Hills, CA 95762
Phone
(760) 608-1873
Fax
(760) 446-3893
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 22102 CA Primary

Addresses

Primary practice location

991 Governor Drive
Suite 104
El Dorado Hills, CA 95762

Mailing address

PO Box 4944
El Dorado Hills, CA 95762
Phone (760) 608-1873

Other names 1

  • Janet Taylor Kowalchick Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170224000791 CA Practitioner - Physical Therapist in Private Practice 4385928001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Revolution Physical Therapy PCGroup PAC ID 5092174987, 12 clinicians

Practice addresses (Care Compare)

2038 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6499
Phone (530) 208-9910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22102CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PT Revolution Physical Therapy, PC Orthopedic CurrentSince Mar 3, 2025 Accepting new patients
Mind Body Physical Therapy P.C. CurrentSince Mar 3, 2025 Accepting new patients

Locations

2038 Lake Tahoe Blvd
South Lake Tahoe, CA 96150
Phone (530) 208-9910

40173 Truckee Airport Rd
Ste 102
Truckee, CA 96161
Phone (530) 999-5787

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770542102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4944",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "95762",
            "telephone_number": "760-608-1873",
            "fax_number": "760-495-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 GOVERNOR DRIVE",
            "address_2": "SUITE 104",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "95762",
            "telephone_number": "760-608-1873",
            "fax_number": "760-446-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCHICK",
        "first_name": "JANET",
        "middle_name": "TAYLOR",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "22102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "KOWALCHICK",
            "middle_name": "TAYLOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.