JACQUELINE KOZAK – Occupational Therapist, NPI 1356056170

JACQUELINE KOZAK is a healthcare provider. based in Georgetown, Texas. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for JACQUELINE KOZAK is 1356056170

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE KOZAK
NPI
1356056170
Phone
(512) 256-7627
Address
3610 Williams Dr
Enumeration Date
16 January 2023
Last Update Date
16 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5122567627
Graduation Year
2019 (7 years ago)
PAC ID
1153795414
Group Practice PAC ID
7810119591
Professional Enrollment ID
I20230328001894
Address ID
TX786282420GE3610XDRXX300

Contacts

Secure Messaging
jackiek@allcaretherapygt.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness85
Years active:3State licenses:0Other namesUpdated within 12 months

825 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for JACQUELINE KOZAK

  • 3610 Williams Dr

    Georgetown, TX 786282420

    Phone: (512) 256-7627

    Type: Location

  • 3610 WILLIAMS DR

    GEORGETOWN, TX 786282420

    Phone:

    Type: Mailing

  • 455 STATE HIGHWAY 195

    GEORGETOWN, TX 786334670

    Phone: (512) 256-7627

    Type: Location

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: 2023-03-28

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
I20230328001894IOccupational Therapist In Private PracticeTXTBD

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 78628)

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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: 7810119591View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeTX
-TX
Occupational Therapist In Private PracticeTX
Qualified Speech Language PathologistTX
Physical Therapist In Private PracticeTX
Occupational Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
-NH
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

How is JACQUELINE KOZAK identified in CMS data?
CMS-hosted NPPES data lists JACQUELINE KOZAK with NPI 1356056170.
Is JACQUELINE KOZAK listed as active for patients and plans?
The listing shows JACQUELINE KOZAK as active in the NPI system.
What taxonomy line describes JACQUELINE KOZAK?
For research purposes, treat JACQUELINE KOZAK as Occupational Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect JACQUELINE KOZAK on a map?
Expect Georgetown, Texas as a primary anchor for JACQUELINE KOZAK unless the record lists multiple sites.
Is the information about JACQUELINE KOZAK up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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