Organization Active NPI

Trinity Rehab Somerset PA

  • Physical Therapy Clinic/Center
  • Conshohocken, PA
National Provider Identifier
1063097640
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
TRINITY REHAB SOMERSET PA
Practice address
200 W Ridge Pike
Conshohocken, PA 19428-3702
Phone
(173) 221-9570
NPI assigned
Mar 15, 2021
Organization subpart
Yes
Parent organization
TRINITY REHAB SOMERSET PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Tonya Gavrielides
Title
Office Manger
Phone
(732) 219-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

200 W Ridge Pike
Conshohocken, PA 19428-3702

Mailing address

554 Highway 35
Red Bank, NJ 07701-5066
Phone (173) 221-9570

Other names 1

  • Trinity Rehab Conshohocken PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210412002013 PA Part B Supplier - Clinic/Group Practice 0547540809 Receives reassigned benefits from 23 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newtown Square, PA; Wayne, PA; North Wales, PA; Newtown, PA; Glen Mills, PA; Dresher, PA; Doylestown, PA; Conshohocken, PA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Trinity Rehab Somerset PA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1063097640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 HIGHWAY 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015066",
            "telephone_number": "173-221-9570",
            "fax_number": "732-334-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W RIDGE PIKE",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194283702",
            "telephone_number": "173-221-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY REHAB SOMERSET PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY REHAB SOMERSET PA",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "GAVRIELIDES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "732-219-5700"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Rehab Conshohocken PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conshohocken, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.