JOHN E KLECZEWSKI, OT — NPI 1962613778 (Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) in SURING, WI)

CMS-1500 Box 24J / 33a • NPI

1962613778

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

225X00000X (CMS 67)

Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)

Box 32 Service Location & ZIP+4

430 MANOR DR, SURING, WI, 54174-9182

✓ 9-Digit EDI 837 ZIP+4 (54174-9182)

Practice Phone & Referral Fax

(920) 842-2191

Fax: (920) 842-2176

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1962613778 (JOHN E KLECZEWSKI, OT) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1962613778` (NPI-1 Individual Practitioner)
Provider / Legal Name	JOHN E KLECZEWSKI, OT
Plain-English Specialty	Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) NUCC Code: `225X00000X` (Occupational Therapist)
Certifying / Licensing Body	National Board for Certification in Occupational Therapy (NBCOT)
Practice Location Address	430 MANOR DR, SURING, WI, 54174-9182
Practice Telephone / Fax	Tel: (920) 842-2191 \| Fax: (920) 842-2176
Administrative Mailing Address	N4575 STATE HIGHWAY 32, KRAKOW, WI, 54137-9087
Enumeration & Last Sync	Enumerated: 2007-05-24 \| CMS Record Updated: 2024-07-12

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

430 MANOR DR, SURING, WI, 54174-9182

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Plain-English Taxonomy & CMS Crosswalk (225X00000X)

What Does Taxonomy Code 225X00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225X00000X translates to:
"Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 67 (Occupational Therapist in Private Practice)
Certifying / Accrediting Authority: National Board for Certification in Occupational Therapy (NBCOT)
Clinical Scope: Regaining hand function, fine motor skills, and independent daily living after stroke, hand injury, or pediatric developmental delay.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JOHN E KLECZEWSKI, OT)

Typical CPT / Diagnostic Procedures:

Activities of Daily Living (ADL) & Neuromuscular Re-Education (CPT 97530–97535)
Upper Extremity Hand Therapy, Custom Splinting & Home Safety Ergonomics

Common Therapeutic Classes:

Non-Pharmacological Functional & Sensory-Motor Rehabilitation Protocols

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225X00000X` — Occupational Therapist Plain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)	State: WI \| License: `3227026` \| Primary: Secondary
`225X00000X` — Occupational Therapist Plain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab)	State: WI \| License: `3227-26` \| Primary: Yes (Primary)

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JOHN E KLECZEWSKI, OT (NPI #1962613778)