Individual provider Active NPI

Andrew J Renaud, DPT

  • Physical Therapist
  • State College, PA
National Provider Identifier
1063431898
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018190 Issued in PA
Practice address
1850 E Park Ave
Suite 112
State College, PA 16803-6706
Phone
(814) 865-3566
Fax
(814) 235-2492
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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 PT018190 PA Primary

Addresses

Primary practice location

1850 E Park Ave
Suite 112
State College, PA 16803-6706

Mailing address

2414 Autumnwood Dr
State College, PA 16801-2485

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000593 PA Practitioner - Physical Therapist in Private Practice 0143306472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Therapy Inc.Group PAC ID 7113100181, 5 clinicians

Practice addresses (Care Compare)

474 Windmere Dr
Suite 100
State College, PA 16801-7643
Phone (814) 308-8482

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Therapy Inc. Physical Therapist CurrentSince Feb 10, 2025 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Feb 1, 2010 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Feb 1, 2010 Accepting new patients

Locations

613 Valley View Blvd
#200
Altoona, PA 16602
Phone (814) 308-8482

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

474 Windmere Dr
Ste 100
State College, PA 16801
Phone (412) 523-7376

1850 E Park Ave
Ste 112
State College, PA 16803
Phone (814) 235-4746

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1063431898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 AUTUMNWOOD DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 112",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-865-3566",
            "fax_number": "814-235-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.