Organization Active NPI

Integrative Rehab Medicine, Inc

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Estero, FL
National Provider Identifier
1821658428
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
INTEGRATIVE REHAB MEDICINE, INC
Practice address
9351 Corkscrew Rd Ste 103
Estero, FL 33928-6801
Phone
(239) 687-3199
NPI assigned
Jun 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Authorized official

Name
Sebastian Klisiewicz, DONPI 1922268697
Title
Owner
Phone
(773) 895-0708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2081S0010X Primary

Addresses

Primary practice location

9351 Corkscrew Rd Ste 103
Estero, FL 33928-6801

Mailing address

9351 Corkscrew Rd Ste 103
Estero, FL 33928-6801
Phone (239) 687-3199

Other identifiers 1

IdentifierTypeStateIssuer
OS12803OtherFLDO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190822000836 FL Part B Supplier - Clinic/Group Practice 5698003135 Receives reassigned benefits from 2 practitioners
Practice locations: Estero, FL
O20210616002801 FL DME Supplier - Physician - Osteopathic Manipulative Medicine 5698003135 Practice locations: Estero, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2170048Integrative Rehab Medicine9351 Corkscrew Rd Suite 103, Estero, FL 33928Certificate of waiverJul 31, 2027

National Provider Directory

National Provider Directory

Locations

9250 Corkscrew Rd
Ste 15
Estero, FL 33928
Phone (239) 400-5639

9351 Corkscrew Rd
#103
Estero, FL 33928
Phone (239) 687-3199

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

345 Executive Pkwy
Ste M4
Rockford, IL 61107
Phone (815) 399-1141

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19930/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1821658428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9351 CORKSCREW RD STE 103",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339286801",
            "telephone_number": "239-687-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9351 CORKSCREW RD STE 103",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339286801",
            "telephone_number": "239-687-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE REHAB MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "KLISIEWICZ",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-895-0708",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DO",
            "identifier": "OS12803",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.