Individual provider Active NPI

Kevin Dao

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1063804565
Registry record updated Feb 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT024048 Issued in PA
Practice address
2601 Holme Ave
Philadelphia, PA 19152-2007
Phone
(215) 335-6000
NPI assigned
Feb 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2015

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 PT024048 PA Primary

Addresses

Primary practice location

2601 Holme Ave
Philadelphia, PA 19152-2007

Mailing address

6774 Chew Ave
B
Philadelphia, PA 19119-1918

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151110002343 PA Practitioner - Physical Therapist in Private Practice 7214247857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jul 19, 2024 Accepting new patients

Locations

300 Welsh Rd
Bldg 1
Horsham, PA 19044

Organizations & group practices 1

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": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424476800000",
    "number": "1063804565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6774 CHEW AVE",
            "address_2": "B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191191918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAO",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-21",
        "last_updated": "2015-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2015; 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.