NPIMap

Individual provider Active NPI

Joseph R Donly

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1104981331
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013159L Issued in PA
Practice address
1331 E Wyoming Ave
Suite 4120
Philadelphia, PA 19124-3808
Phone
(215) 831-1170
Fax
(215) 744-7394
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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 PT013159L PA Primary

Addresses

Primary practice location

1331 E Wyoming Ave
Suite 4120
Philadelphia, PA 19124-3808

Mailing address

2 W 10TH St
Marcus Hook, PA 19061-4513
Phone (610) 859-8850

Other identifiers 7

IdentifierTypeStateIssuer
0188461701OtherPAAMERICHOICE
0015717000OtherPAIBC
01884617MedicaidPA
1160738OtherKEYSTONE MERCY
053903VLZOtherPAMEDICARE ID
DO343174OtherPAPA BL SHIELD
P00692850OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013159LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist PastSince Jun 1, 2017 Accepting new patients
Dynamic Therapy Services of Pennsylvania LLC Physical Therapist Past Accepting new patients
Patch Technique PLLC PastSince Apr 23, 2023 Accepting new patients
Progress PT Centers for Fitness and Rehabilitation LLC Physical Therapist Past Accepting new patients
Progress Physical Therapy LLC Physical Therapist PastSince Jan 21, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1104981331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 10TH ST",
            "city": "MARCUS HOOK",
            "state": "PA",
            "postal_code": "190614513",
            "telephone_number": "610-859-8850",
            "fax_number": "610-859-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 E WYOMING AVE",
            "address_2": "SUITE 4120",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243808",
            "telephone_number": "215-831-1170",
            "fax_number": "215-744-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONLY",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT013159L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0188461701",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0015717000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01884617",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1160738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "053903VLZ",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BL SHIELD",
            "identifier": "DO343174",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00692850",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.