Cory Michael Birckbichler, D.P.T.
Individual provider Active NPI Physical Therapist · Apollo, PA
NPI 1104888031 · NPPES record last updated Aug 7, 2013
Key facts
- NPI
- 1104888031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT015964 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060126000298 | PA | Practitioner - Physical Therapist in Private Practice | 7517971880 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keystone Rehabilitation Systems, Inc. | Current |
Accepting new patients | |
| Keystone Rehabilitation Systems, Inc. | Current | Accepting new patients | |
| Keystone Rehabilitation Systems Inc | Past | Accepting new patients | |
| PT Group Acquisition LLC | Physical Therapist | Past |
Accepting new patients |
| Keystone Rehabilitation Systems Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT015964 | PA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 072904UY6 | Other | PA | MEDICARE |
| 0019666970001 | Medicaid | PA |
Other providers in Apollo, PA
- Ageless Senior in Home Care
- Alle-Kiski Caregivers, LLC
- Amy Kay Altomari
- John N Angelini
- Maycen Anthony
- Richard J Boden
- Howard L Cacco
- Samantha Calderone
- Matthew Cellitti
- Cherry Lane Manor
All providers in Apollo, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.