Active NPI
Colleen M Dibernardo, M.S.P.T.
- Physical Therapist
- West Chester, PA
National Provider Identifier
1043412380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT017842
- Practice address
- 915 Old Fern Hill Rd
Suite 4
West Chester, PA 19380-4269 - Phone
- (610) 738-2480
- Fax
- (610) 738-2485
- NPI assigned
- May 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT017842 | PA | Primary |
Addresses
Primary practice location
915 Old Fern Hill Rd
Suite 4
West Chester, PA 19380-4269
Mailing address
1312 Morstein Rd
West Chester, PA 19380-3608
Phone (610) 696-3694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11867 W Main St
Wolcott, NY 14590-1025
Phone (315) 635-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20004 | NY | MD | Psychologist |
| PT017842 | PA | MD | Physical Therapist |
| 020004 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onondaga Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Onondaga Physical Therapy | Physical Therapist | Current | Accepting new patients |
| Onondaga Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
| Riccardi & Burton Physical Therapy P.C. | Physical Therapist | Past | Accepting new patients |
| Onondaga Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Locations
19 E Genesee St
Ste 103
Baldwinsville, NY 13027
8390 Oswego Rd
Liverpool, NY 13090
Phone (315) 652-4323
11867 W Main St
Wolcott, NY 14590
Phone (315) 877-9747
Organizations & group practices 5
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.
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- Physical Therapist
- Wolcott, NY
- NPI 1689931461
-
- Physical Therapist
- Syracuse, NY
- NPI 1811094402
-
- Physical Therapist
- Baldwinsville, NY
- NPI 1548367139
-
- Physical Therapist
- La Fayette, NY
- NPI 1073662813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043412380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 MORSTEIN RD",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193803608",
"telephone_number": "610-696-3694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 OLD FERN HILL RD",
"address_2": "SUITE 4",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193804269",
"telephone_number": "610-738-2480",
"fax_number": "610-738-2485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBERNARDO",
"first_name": "COLLEEN",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "M.S.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT017842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.