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Tesse Lane Maciejko, DPT

NPI 1366092272ActiveIndividual· Physical Therapist· Winthrop, WA

Physical Therapist (DPT) with Saco Bay Orthopaedic and Sports Physical Therapy Inc and 1 other group, practicing in Winthrop, Washington. Enrolled in Medicare as practitioner - physical therapist in private practice and practitioner - physical therapist in private practice.

Overview

NPI1366092272
StatusActive
Entity typeIndividual
CredentialDPT
Sole proprietorNo
NPI issuedSep 13, 2019
Last updated in NPPESSep 25, 2026
Certified by providerSep 25, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Physical Therapist Primary225100000XPTL.0016628CO
Physical Therapist225100000XPT7383ME
Physical Therapist225100000X196622AK
Physical Therapist225100000XPT.PT.70135962WA
Physical Therapist225100000X21536MT
Physical Therapist225100000X318VI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Physical Therapist in Private Practice (CO); Practitioner - Physical Therapist in Private Practice (ME); Practitioner - Physical Therapist in Private Practice (VI)

Medicare sources and data years

Education and affiliations

Graduation year2019
Medicare specialtyPhysical Therapist In Private Practice

Medical groups

Source: CMS Care Compare

Other physical therapists in Winthrop

All physical therapists in Washington