Individual provider Active NPI

Dylan Greenblatt, DPT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1043901044
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305215717 Issued in VA
Practice address
5604A Virginia Beach Blvd
Virginia Beach, VA 23462-5681
Phone
(757) 455-5000
NPI assigned
May 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305215717 VA Primary

Addresses

Primary practice location

5604A Virginia Beach Blvd
Virginia Beach, VA 23462-5681

Mailing address

1055 W 38TH St Apt 245
Norfolk, VA 23508-2668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703001270 VA Practitioner - Physical Therapist in Private Practice 6709245194 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Therapy Solutions, LLC Physical Therapist CurrentSince Mar 16, 2024 Accepting new patients
JP Therapy, LLC CurrentSince May 22, 2023 Accepting new patients
Sentara Therapy Solutions, LLC Physical Therapist CurrentSince Mar 16, 2024 Accepting new patients

Locations

984B Laskin Rd
Virginia Beach, VA 23451
Phone (757) 395-6900

5604 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462

928 Diamond Springs Rd
Ste 103
Virginia Beach, VA 23455
Phone (757) 395-1975

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1043901044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 W 38TH ST APT 245",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235082668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604A VIRGINIA BEACH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625681",
            "telephone_number": "757-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBLATT",
        "first_name": "DYLAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.