Individual provider Active NPI

Grzegorz Koziel, DPT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1902652043
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070028028 Issued in IL
Practice address
5000 W Chambers St
Milwaukee, WI 53210-1650
Phone
(414) 447-2211
NPI assigned
Apr 29, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 070028028 IL Primary

Addresses

Primary practice location

5000 W Chambers St
Milwaukee, WI 53210-1650

Mailing address

6331 W 63Rd St Unit 2a
Chicago, IL 60638-5074

Other practice location 1

396 Remington Blvd Ste 255
Bolingbrook, IL 60440-4306
Phone (630) 312-5901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114000879 CA Practitioner - Physical Therapist in Private Practice 6800324120 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070028028ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JBJC Inc. Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients
JBJC Inc CurrentSince Dec 11, 2024 Accepting new patients

Locations

6385 Pacific Ave
Stockton, CA 95207
Phone (209) 477-9300

534 E Pine St
Ste A
Stockton, CA 95204
Phone (209) 463-5800

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": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1902652043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 W 63RD ST UNIT 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606385074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W CHAMBERS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101650",
            "telephone_number": "414-447-2211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "396 Remington Blvd Ste 255",
            "address_purpose": "LOCATION",
            "city": "Bolingbrook",
            "state": "IL",
            "postal_code": "604404306",
            "country_code": "US",
            "telephone_number": "630-312-5901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZIEL",
        "first_name": "GRZEGORZ",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028028",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 29, 2024; 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.