JARED P KAZMIERCZAK (DPT) – Physical Therapist, NPI 1265297956

JARED P KAZMIERCZAK (DPT) is a healthcare provider. based in Fort wayne, Indiana. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. The NPI Number for JARED P KAZMIERCZAK (DPT) is 1265297956

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
JARED P KAZMIERCZAK (DPT)
NPI
1265297956
Phone
(260) 739-0300
Address
12722 TONKEL RD STE 102
Enumeration Date
21 February 2024
Last Update Date
21 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2607390300
Graduation Year
2024 (2 years ago)
PAC ID
8921541053
Group Practice PAC ID
4385962497
Professional Enrollment ID
I20240618001523
Address ID
IN468458201FO12722RDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

1,866 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN

Provider Addresses for JARED P KAZMIERCZAK (DPT)

  • 12722 TONKEL RD STE 102

    FORT WAYNE, IN 468458201

    Phone: (260) 739-0300

    Fax: (260) 818-2299

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240618001523IPhysical Therapist In Private PracticeINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46845)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385962497View full group profile
NameSpecialtyState
-IN
Occupational Therapist In Private PracticeIN
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeIN

Reviews

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Frequently asked questions

Is there an official ID for JARED P KAZMIERCZAK (DPT) in U.S. healthcare records?
The official identifier for JARED P KAZMIERCZAK (DPT) is NPI 1265297956.
Would JARED P KAZMIERCZAK (DPT) appear as active to a payer?
You can treat JARED P KAZMIERCZAK (DPT) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is JARED P KAZMIERCZAK (DPT)?
JARED P KAZMIERCZAK (DPT) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for JARED P KAZMIERCZAK (DPT)?
Travel planning: use Fort Wayne, Indiana as the reference point for JARED P KAZMIERCZAK (DPT), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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