NICHOLAS KACZKOWSKI PT, DPT, MS
NPI 1083219596
Physical Therapist in Fox Lake, IL
About Nicholas Kaczkowski Pt, Dpt, Ms NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICHOLAS KACZKOWSKI PT, DPT, MS (NPI 1083219596) is an individual physical therapist in Fox Lake, Illinois, licensed in Illinois (070025353) and active in the NPI registry since December 2020.
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Nicholas Kaczkowski Pt, Dpt, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Nicholas Kaczkowski reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Salem, WI 53168
- Reassigned Medicare billing, Wisconsin enrollment
- Medicare enrollment name: Advantage Physical Therapy & Sports Rehab, LLC
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Nicholas Kaczkowski's NPI number?
The NPI number for Nicholas Kaczkowski is 1083219596. It was assigned to this individual provider in the NPPES registry on December 2, 2020.
Where is Nicholas Kaczkowski located?
Nicholas Kaczkowski practices at 145 Sayton Rd Ste F, Fox Lake, IL 60020. The listed phone number is (847) 629-5536.
What is Nicholas Kaczkowski's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Nicholas Kaczkowski enrolled in Medicare?
Yes. Nicholas Kaczkowski is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Nicholas Kaczkowski's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Kaczkowski reassigns Medicare benefits to Advantage Pt & Sports Rehab LLC (Salem, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicholas Kaczkowski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nicholas Kaczkowski accept?
Health plans from Anthem Blue Cross and Blue Shield and Security Health Plan list Nicholas Kaczkowski as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Nicholas Kaczkowski was last updated on December 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.