Individual provider Active NPI

Kathleen Lukaszewicz, P.T., PH.D.

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1770644643
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10484-024 Issued in WI
Practice address
604 N 16TH St
Milwaukee, WI 53233-2117
Phone
(414) 453-8616
Fax
(414) 453-6150
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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 10484-024 WI Primary

Addresses

Primary practice location

604 N 16TH St
Milwaukee, WI 53233-2117

Mailing address

2849 N Pierce St
Unit C
Milwaukee, WI 53212-2548
Phone (414) 288-3382

Other identifiers 1

IdentifierTypeStateIssuer
40463100MedicaidWI

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10484-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Injury Rehabilitation Clinic II, Inc. Physical Therapist PastSince Jan 1, 2000 Accepting new patients
Sport Clinic of Greater Milwaukee Physical Therapist PastSince Jul 31, 2017 Accepting new patients

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1770644643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2849 N PIERCE ST",
            "address_2": "UNIT C",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122548",
            "telephone_number": "414-288-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332117",
            "telephone_number": "414-453-8616",
            "fax_number": "414-453-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASZEWICZ",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "P.T., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10484-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40463100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.