Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathleen Polak, PT

Individual provider Specialist · NPI 1013329333

Kathleen Polak, PT is a Physical Therapist in Private Practice in Port Jefferson, New York. Qualified in 2013, 13 years ago. Practices with Sports Physical Therapy Occupational Therapy and Rehabilitation Servic, a 529-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
13
Licensed in
NY
In the registry since
2014
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

635 Belle Terre Rd Ste 204
Port Jefferson, NY 11777-1977
Phone: (631) 474-0008
Fax: (631) 474-0224
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 037194 (NY)

Record details

NPI number1013329333
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedMay 21, 2014
Last updated in NPPESJune 9, 2023
Certification dateMay 22, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Sports Physical Therapy Occupational Therapy And Rehabilitation Servic — 529 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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