Individual provider Active NPI

Lisa S Fogelman, DPT

  • Physical Therapist
  • Gilbertsville, PA
National Provider Identifier
1154340370
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017982 Issued in PA
Practice address
1806 Swamp Pike
Suite 100
Gilbertsville, PA 19525-9307
Phone
(610) 327-2600
Fax
(610) 327-9050
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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 PT017982 PA Primary

Addresses

Primary practice location

1806 Swamp Pike
Suite 100
Gilbertsville, PA 19525-9307

Mailing address

1806 Swamp Pike
Suite 100
Gilbertsville, PA 19525-9307
Phone (610) 327-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080610000603 PA Practitioner - Physical Therapist in Private Practice 2466468780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

1122 Hwy 315 Blvd
Wilkes Barre, PA 18702-6943
Phone (877) 407-3422

470 N Lewis Rd
Bon Homie LTD Adult Day Center
Limerick, PA 19468-1511
Phone (610) 792-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017982PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients
Dynamic Physical Therapy Physical Therapist Past Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist Past Accepting new patients
Dynamic Therapy Services LLC Physical Therapist PastSince Nov 29, 2016 Accepting new patients

Locations

470 N Lewis Rd
Limerick, PA 19468
Phone (610) 792-8800

1122 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (877) 407-4322

Organizations & group practices 4

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1154340370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 SWAMP PIKE",
            "address_2": "SUITE 100",
            "city": "GILBERTSVILLE",
            "state": "PA",
            "postal_code": "195259307",
            "telephone_number": "610-327-2600",
            "fax_number": "610-327-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 SWAMP PIKE",
            "address_2": "SUITE 100",
            "city": "GILBERTSVILLE",
            "state": "PA",
            "postal_code": "195259307",
            "telephone_number": "610-327-2600",
            "fax_number": "610-327-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGELMAN",
        "first_name": "LISA",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbertsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.