Individual provider Active NPI

Shon Jay Grosse, PT

  • Physical Therapist
  • Colmar, PA
National Provider Identifier
1154469096
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2304 N Broad St
Colmar, PA 18915-9725
Phone
(215) 997-1160
Fax
(215) 997-3798
NPI assigned
Feb 2, 2007
Last updated
Sep 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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 Primary

Addresses

Primary practice location

2304 N Broad St
Colmar, PA 18915-9725

Mailing address

PO Box 507
Montgomeryville, PA 18936-0507
Phone (215) 997-1160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120808000327 PA Practitioner - Physical Therapist in Private Practice 3476515891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Hahnemann University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2304 N Broad St
Colmar, PA 18915-9725
Phone (215) 997-1160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Physical Therapy and Fitness, LLC Physical Therapist CurrentSince Aug 1, 2002 Accepting new patients

Locations

2304 N Broad St
Colmar, PA 18915
Phone (215) 822-5400

2621 N Broad St
#F
Colmar, PA 18915
Phone (215) 822-5400

Organizations & group practices 1

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1154469096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 507",
            "city": "MONTGOMERYVILLE",
            "state": "PA",
            "postal_code": "189360507",
            "telephone_number": "215-997-1160",
            "fax_number": "215-997-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 N BROAD ST",
            "city": "COLMAR",
            "state": "PA",
            "postal_code": "189159725",
            "telephone_number": "215-997-1160",
            "fax_number": "215-997-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSE",
        "first_name": "SHON",
        "middle_name": "JAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colmar, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.