NPIMap

Organization Active NPI

Activecare Physical Therapy

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1023388949
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVECARE PHYSICAL THERAPY
Practice address
3425 Peach St
Erie, PA 16508-2779
Phone
(814) 864-4100
Fax
(814) 866-1811
NPI assigned
Jan 9, 2012
Last updated
Jan 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
George Ehren Trost, MPTNPI 1083624159
Title
Physical Therapist
Phone
(814) 864-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

3425 Peach St
Erie, PA 16508-2779

Mailing address

3425 Peach St
Erie, PA 16508-2779
Phone (814) 864-4100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120327000422 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3971763012 Receives reassigned benefits from 4 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

3425 Peach St
Erie, PA 16508
Phone (814) 450-5463

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1023388949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082779",
            "telephone_number": "814-864-4100",
            "fax_number": "814-866-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082779",
            "telephone_number": "814-864-4100",
            "fax_number": "814-866-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVECARE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "TROST",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "EHREN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "814-864-4100",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.