Individual provider Active NPI

Cory Michael Birckbichler, D.P.T.

  • Physical Therapist
  • Apollo, PA
National Provider Identifier
1104888031
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015964 Issued in PA
Practice address
4203 State Route 66
Suite 102
Apollo, PA 15613-1532
Phone
(724) 727-7915
Fax
(724) 727-3936
NPI assigned
Apr 5, 2006
Last updated
Aug 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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 PT015964 PA Primary

Addresses

Primary practice location

4203 State Route 66
Suite 102
Apollo, PA 15613-1532

Mailing address

4203 State Route 66
Suite 102
Apollo, PA 15613-1532
Phone (724) 727-7915

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060126000298 PA Practitioner - Physical Therapist in Private Practice 7517971880 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Rehabilitation Systems, Inc. Current Accepting new patients
Keystone Rehabilitation Systems, Inc. CurrentSince Jun 16, 2022 Accepting new patients
Keystone Rehabilitation Systems Inc Past Accepting new patients
PT Group Acquisition LLC Physical Therapist PastSince Sep 4, 2012 Accepting new patients

Organizations & group practices 5

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1104888031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 STATE ROUTE 66",
            "address_2": "SUITE 102",
            "city": "APOLLO",
            "state": "PA",
            "postal_code": "156131532",
            "telephone_number": "724-727-7915",
            "fax_number": "724-727-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 STATE ROUTE 66",
            "address_2": "SUITE 102",
            "city": "APOLLO",
            "state": "PA",
            "postal_code": "156131532",
            "telephone_number": "724-727-7915",
            "fax_number": "724-727-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRCKBICHLER",
        "first_name": "CORY",
        "middle_name": "MICHAEL",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apollo, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.