NPIMap

Organization Active NPI

Penn Therapy Associates, Inc.

  • Physical Therapist
  • Havertown, PA
National Provider Identifier
1104880590
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT003694L Issued in PA
Legal business name
PENN THERAPY ASSOCIATES, INC.
Practice address
2010 W Chester Pike
Suite 450
Havertown, PA 19083-2700
Phone
(610) 853-0508
Fax
(610) 853-3837
NPI assigned
Apr 13, 2006
Last updated
Apr 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Authorized official

Name
Mark E. Reitz, PTNPI 1205890597
Title
Owner/President
Phone
(610) 853-0508

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT003694L PA Primary

Addresses

Primary practice location

2010 W Chester Pike
Suite 450
Havertown, PA 19083-2700

Mailing address

2010 W Chester Pike
Suite 450
Havertown, PA 19083-2700
Phone (610) 853-0508

Other identifiers 2

IdentifierTypeStateIssuer
0775764000OtherPAIBC GROUP #
PE844978OtherPABC/BS-MAJOR MEDICAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051207000130 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5698795565 Receives reassigned benefits from 11 practitioners
Practice locations: Havertown, PA

National Provider Directory

National Provider Directory

Locations

2010 W Chester Pike
Ste 450
Havertown, PA 19083
Phone (610) 853-0508

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1104880590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W CHESTER PIKE",
            "address_2": "SUITE 450",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832700",
            "telephone_number": "610-853-0508",
            "fax_number": "610-853-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W CHESTER PIKE",
            "address_2": "SUITE 450",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832700",
            "telephone_number": "610-853-0508",
            "fax_number": "610-853-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN THERAPY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "REITZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "610-853-0508",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT003694L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC GROUP #",
            "identifier": "0775764000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS-MAJOR MEDICAL",
            "identifier": "PE844978",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.