Individual provider Active NPI

Amy Marie Dalessandro, M.P.T.

  • Physical Therapist
  • Bryn Mawr, PA
National Provider Identifier
1104816313
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009672L Issued in PA
Practice address
931 E Haverford Rd
Bryn Mawr, PA 19010-3838
Phone
(610) 527-7870
Fax
(610) 527-2337
NPI assigned
Oct 27, 2005
Last updated
Sep 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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 PT009672L PA Primary

Addresses

Primary practice location

931 E Haverford Rd
Bryn Mawr, PA 19010-3838

Mailing address

931 E Haverford Rd
Bryn Mawr, PA 19010-3838
Phone (610) 527-7870

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121023000107 PA Practitioner - Physical Therapist in Private Practice 3173773462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

372 W Lancaster Ave
Wayne, PA 19087-3924
Phone (610) 688-8807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT009672LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Radnor Family Practice, PLLC, Dba Im Health CurrentSince Jan 15, 2024 Accepting new patients
Radnor Family Practice Professional Limited Liability Company Physical Therapist CurrentSince Jan 15, 2024 Accepting new patients

Locations

372 W Lancaster Ave
Wayne, PA 19087
Phone (610) 688-8807

372 W Lancaster Ave
Fl 3
Wayne, PA 19087

Organizations & group practices 2

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1104816313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 E HAVERFORD RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103838",
            "telephone_number": "610-527-7870",
            "fax_number": "610-527-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E HAVERFORD RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103838",
            "telephone_number": "610-527-7870",
            "fax_number": "610-527-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALESSANDRO",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT009672L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.