Individual provider Active NPI

Eric Ciabattoni

  • Orthopedic Physical Therapist
  • Berwyn, PA
National Provider Identifier
1013457175
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT025865 Issued in PA
Practice address
1175 Lancaster Ave
Berwyn, PA 19312-1297
Phone
(610) 651-8282
Fax
(610) 651-8213
NPI assigned
Mar 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT025865 PA Primary

Addresses

Primary practice location

1175 Lancaster Ave
Berwyn, PA 19312-1297

Mailing address

1175 Lancaster Ave
Berwyn, PA 19312-1297
Phone (610) 651-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210413002556 MI Practitioner - Physical Therapist in Private Practice 2163708520 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT025865PAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital CurrentSince Mar 1, 2021 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince Mar 1, 2021 Accepting new patients

Locations

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

4025 Chums Village Dr
Traverse City, MI 49685
Phone (231) 252-3433

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Free Bed Rehabilitation Hospital 135 clinicians

Practice addresses (Care Compare)

5191 Rosewood Dr
Traverse City, MI 49685-9137
Phone (231) 946-1979

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1013457175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 LANCASTER AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121297",
            "telephone_number": "610-651-8282",
            "fax_number": "610-651-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 LANCASTER AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121297",
            "telephone_number": "610-651-8282",
            "fax_number": "610-651-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIABATTONI",
        "first_name": "ERIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT025865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.