Kenneth Joseph Kaczka, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT38655 Issued in FL

Practice address

105 Murabella Pkwy Ste 6
St Augustine, FL 32092-4540

Phone

(904) 224-2666

Fax

(904) 224-2667

NPI assigned

Jun 29, 2022

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

87.01 of 100Reported as group

Improvement activities

40

Cost

74.03

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.

• Jacksonville Orthopaedic Institute Inc

  • Physical Therapist
  • St Augustine, FL
  • NPI 1649826900
  NPD
• Jacksonville Orthopaedic Institute Inc

  • Physical Therapist
  • Fernandina Beach, FL
  • NPI 1942660212
  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1922730811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117345",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687345",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MURABELLA PKWY STE 6",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320924540",
            "telephone_number": "904-224-2666",
            "fax_number": "904-224-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZKA",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Myron Justice, M.D.
• Yesenia E Justiniano Rosario, M.D.
• Vivian Juvan, LCSW
• JVL Mevent PLLC (Sunshine Kids Pediatrics)
• K&TS Healthcare Services, LLC (KindHeart Home Care)
• Vickie Lynn Kaiser, D.M.D.
• Kall for Kare, LLC
• Kall for Kare, LLC
• Kall for Kare, LLC
• Zane G Kalter, M.D.

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.