Individual provider Active NPI

Camryn Alyn Pacholski, PT

  • Physical Therapist
  • Dubuque, IA
National Provider Identifier
1942007299
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
129124 Issued in IA
Practice address
2300 John F Kennedy Rd
Dubuque, IA 52002-2843
Phone
(563) 588-3891
Fax
(563) 588-3893
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 129124 IA Primary

Addresses

Primary practice location

2300 John F Kennedy Rd
Dubuque, IA 52002-2843

Mailing address

2300 John F Kennedy Rd
Dubuque, IA 52002-2843
Phone (563) 588-3891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331001496 IA Practitioner - Physical Therapist in Private Practice 2769905702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason E Meyer Physical Therapy PCGroup PAC ID 8325136617, 15 clinicians

Practice addresses (Care Compare)

2300 John F Kennedy Rd
Suite 1
Dubuque, IA 52002-2843
Phone (563) 588-3891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jason E Meyer Physical Therapy PC CurrentSince Mar 1, 2025 Accepting new patients
Dubuque Pediatric Therapies Physical Therapist PastSince Mar 11, 2025 Accepting new patients

Locations

2300 John F Kennedy Rd
Ste 1
Dubuque, IA 52002
Phone (563) 588-3891

2300 John F Kennedy Rd
Dubuque, IA 52002
Phone (563) 588-3891

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": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1942007299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 JOHN F KENNEDY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022843",
            "telephone_number": "563-588-3891",
            "fax_number": "563-588-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 JOHN F KENNEDY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022843",
            "telephone_number": "563-588-3891",
            "fax_number": "563-588-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHOLSKI",
        "first_name": "CAMRYN",
        "middle_name": "ALYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "129124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.