Individual provider Active NPI

Susan Marie Dwyer, PT

  • Physical Therapist
  • Plains, PA
National Provider Identifier
1104830769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018472 Issued in PA
Practice address
1086 Route 315
Plains, PA 18702
Phone
(570) 823-7761
Fax
(570) 822-8033
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT018472 PA Primary
Physical Therapist 225100000X 0185481 NY

Addresses

Primary practice location

1086 Route 315
Plains, PA 18702

Mailing address

1086 Route 315
Pro Rehabilitation Services
Plains, PA 18702
Phone (570) 823-7761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213001243 PA Practitioner - Physical Therapist in Private Practice 8820191026 Reassigns benefits to 4 organizations

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
Steffie Enterprises, Inc 38 clinicians

Practice addresses (Care Compare)

1157 Lackawanna TRL
Clarks Summit, PA 18411-9260
Phone (570) 586-7764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0185481NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dylan RC Enterprises Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Steffie Enterprises, Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Alycam Inc Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Derek Enterprises LLC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients
Prohealth Care Associates LLP Past Accepting new patients
Mount Kisco Medical Group Past Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist Past Accepting new patients

Locations

1157 Lackawanna Trl
Clarks Summit, PA 18411
Phone (570) 283-3222

87 Oxford St
Hanover Township, PA 18706
Phone (570) 387-2202

693 Main St
New Milford, PA 18834
Phone (570) 465-2027

66 E Tioga St
Tunkhannock, PA 18657
Phone (570) 836-1078

106 Rotary Dr
West Hazleton, PA 18202
Phone (570) 455-2286

1086 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (570) 823-7761

Organizations & group practices 7

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104830769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 ROUTE 315",
            "address_2": "PRO REHABILITATION SERVICES",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-7761",
            "fax_number": "570-822-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 ROUTE 315",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-7761",
            "fax_number": "570-822-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018472",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0185481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plains, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.