Jacquelyn Povilaitis, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012236 Issued in AZ

Practice address

7810 N US Highway 89 Ste 270-280
Flagstaff, AZ 86004-6255

Phone

(928) 522-8375

NPI assigned

Oct 27, 2021

Sex

Female

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 AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.13 of 100Reported as group

Quality

66.85

Promoting interoperability

99

Improvement activities

40

Cost

74.4

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Northern Arizona Healthcare Corporation

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1669914552
  Medicare reassignment Care Compare group NPD
• Northern Arizona Healthcare Corporation

  • Physical Therapist
  • Flagstaff, AZ
  • NPI 1003509688
  NPD
• Northern Arizona Healthcare Corporation

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1235732702
  NPD

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1790449650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7810 N US HIGHWAY 89 STE 270-280",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860046255",
            "telephone_number": "928-522-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 N US HIGHWAY 89 STE 270-280",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860046255",
            "telephone_number": "928-522-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVILAITIS",
        "first_name": "JACQUELYN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "012236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Porvaznik Family Medicine PLLC
• Mary Catherine Porvaznik, MD
• Andrew Post, MA
• Kaitlyn E Post, DPT
• Rebecca Poulter, PHARMD
• Robert Andre Powell II, M.S.
• James Michael Powers, M.ED.
• Michelle Linette Powers, MSED
• Pparinc
• Charinale Elorta Prado, NP

• Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.