Individual provider Active NPI

Jonas Chan

  • Physical Therapist
  • Wexford, PA
National Provider Identifier
1073306718
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT033347 Issued in PA
Practice address
12620 Perry Hwy
Wexford, PA 15090-8662
Phone
(724) 816-3583
NPI assigned
May 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 PT033347 PA Primary

Addresses

Primary practice location

12620 Perry Hwy
Wexford, PA 15090-8662

Mailing address

12620 Perry Hwy
Wexford, PA 15090-8662
Phone (724) 816-3583

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729004004 PA Practitioner - Physical Therapist in Private Practice 9032626544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Unlimited by Dan Glatz LLCGroup PAC ID 2062664436, 4 clinicians

Practice addresses (Care Compare)

12620 Perry Hwy
Wexford, PA 15090-8662
Phone (724) 816-3583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT033347PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Unlimited by Dan Glatz LLC CurrentSince Jun 30, 2025 Accepting new patients

Locations

12620 Perry Hwy
Wexford, PA 15090
Phone (724) 816-3583

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": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1073306718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908662",
            "telephone_number": "724-816-3583",
            "fax_number": "724-816-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908662",
            "telephone_number": "724-816-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JONAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT033347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.