Teddy Kajkowski, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2933 Issued in ME

Practice address

735 Wilson St
Brewer, ME 04412

Phone

(207) 989-1567

Fax

(207) 989-2287

NPI assigned

Jul 4, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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 and National Provider Directory roles.

• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1427169010
  Medicare reassignment NPD
• Penobscot Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1083259410
  NPD
• Penobscot Community Health Center

  • Clinical Medical Laboratory
  • Bangor, ME
  • NPI 1659464584
  NPD
• Penobscot Community Health Center

  • Hearing and Speech Clinic/Center
  • Bangor, ME
  • NPI 1285685628
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1801826896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 WILSON ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-989-1567",
            "fax_number": "207-989-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJKOWSKI",
        "first_name": "TEDDY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432298299",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corinne Johnston, LSW
• Pauline Kay Johnston, MD
• Lindsay E Jones, PA
• Christopher Jordan, CTRS
• Jay Joseph, MD
• Khalil Kamar
• Michelle Kasap-Gomes, PTA
• Taylor Forrest Kelley, LCPC
• Patricia Ann Kenaley, FNP
• Emily Ketch, OD

• Physical Therapist in Brewer, ME
• Providers in Brewer, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.