Individual provider Active NPI

Dale Alan Danielson, PT

  • Physical Therapist
  • Middletown, OH
National Provider Identifier
1154475341
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT005190 Issued in OH
Practice address
323 N Breiel Blvd
Middletown, OH 45042-3868
Phone
(513) 420-1700
Fax
(513) 420-9700
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT005190 OH Primary

Addresses

Primary practice location

323 N Breiel Blvd
Middletown, OH 45042-3868

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080311000056 OH Practitioner - Physical Therapist in Private Practice 3577648914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

3016 Far Hills Ave
Kettering, OH 45429-2510
Phone (937) 886-4275

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT005190OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients
Womanline of Dayton, Inc Past Accepting new patients

Locations

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

3016 Far Hills Ave
Kettering, OH 45429
Phone (937) 886-4275

323 N Breiel Blvd
Middletown, OH 45042
Phone (513) 420-1700

4925 Jackman Rd
Ste 34
Toledo, OH 43613
Phone (567) 318-1000

Organizations & group practices 3

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154475341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423868",
            "telephone_number": "513-420-1700",
            "fax_number": "513-420-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "DALE",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT005190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.