Individual provider Active NPI

Violeta Pesa, PT

  • Physical Therapist
  • Montoursville, PA
National Provider Identifier
1093190696
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT023619 Issued in PA
Practice address
1445 Sycamore Rd
Montoursville, PA 17754-9519
Phone
(570) 601-8100
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 PT023619 PA Primary

Addresses

Primary practice location

1445 Sycamore Rd
Montoursville, PA 17754-9519

Mailing address

1600 Sycamore Rd Apt 11
Montoursville, PA 17754-9587
Phone (954) 803-7258

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815002175 NV Practitioner - Physical Therapist in Private Practice 4082076534 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT023619PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Meadow Therapy Services LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Nevada Rehab Resources LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Spring Mountain Rehab, LLC Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients

Locations

5155 S Durango Dr
Ste 101
Las Vegas, NV 89113
Phone (702) 478-2424

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": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1093190696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SYCAMORE RD APT 11",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177549587",
            "telephone_number": "954-803-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SYCAMORE RD",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177549519",
            "telephone_number": "570-601-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESA",
        "first_name": "VIOLETA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montoursville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.