Sebastian Klisiewicz, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

OS12803 Issued in FL

Practice address

9250 Corkscrew Rd Ste 15
Estero, FL 33928

Phone

(239) 687-3199

Fax

(855) 398-9437

NPI assigned

Jun 16, 2008

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

Midwestern University, Chicago College of Osteopathic Med, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: integrativerehabmedicine.sebastianklisiewicz@144956.advancedmd-direct.com
• FHIR API: https://api.platform.athenahealth.com/19930/brand/1/csg/1/fhir/r4

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.

• Integrative Rehab Medicine, Inc

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Estero, FL
  • NPI 1821658428
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1922268697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 CORKSCREW RD STE 15",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283217",
            "telephone_number": "773-895-0708",
            "fax_number": "855-398-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 CORKSCREW RD STE 15",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "33928",
            "telephone_number": "239-687-3199",
            "fax_number": "855-398-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLISIEWICZ",
        "first_name": "SEBASTIAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "OS12803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013013900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reid Kirchhoff, MSED, LMHC
• Jessica Lynn Kirchner, PT
• Kathryn Marie Kirk, NP
• Nicole Klersy-Mohr, D.C., CFMP
• Eunika Klisiewicz, A.P.,D.O.M
• Steven Lee Knepper, DDS
• Konowal Vision Inc
• Alexandra Konowal, DO
• Benjamin John Konynenbelt, O.D.
• Jessie Elizabeth Konynenbelt, O.D.

• Physical Medicine & Rehabilitation Physician in Estero, FL
• Providers in Estero, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.