NPIMap

Individual provider Active NPI

Joseph John Disandro, PTA

  • Physical Therapy Assistant
  • Baton Rouge, LA
National Provider Identifier
1114153251
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
2645 O'Neal Lane BLDG C, Ste D
Baton Rouge, LA 70816-3179
Phone
(225) 751-3696
Fax
(225) 751-3697
NPI assigned
Jun 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

2645 O'Neal Lane BLDG C, Ste D
Baton Rouge, LA 70816-3179

Mailing address

2645 O'Neal Lane BLDG C, Ste D
Baton Rouge, LA 70816-3179
Phone (225) 751-3696

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Therapy Past Accepting new patients
Physical Therapy of Baton Rouge, Inc Past Accepting new patients

Organizations & group practices 2

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1114153251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 O'NEAL LANE BLDG C, STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708163179",
            "telephone_number": "225-751-3696",
            "fax_number": "225-751-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 O'NEAL LANE BLDG C, STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708163179",
            "telephone_number": "225-751-3696",
            "fax_number": "225-751-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISANDRO",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.