Active NPI
Optimal Home Rehab, LLC
- Physical Therapist
- Philadelphia, PA
National Provider Identifier
1154885291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- OPTIMAL HOME REHAB, LLC
- Practice address
- 4902 Arch St
Philadelphia, PA 19139-2727 - Phone
- (267) 225-7775
- NPI assigned
- Jan 23, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Doriean Yasmeen Broady, PT
- Title
- Owner
- Phone
- (267) 225-7775
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
4902 Arch St
Philadelphia, PA 19139-2727
Mailing address
721 Daly St
Philadelphia, PA 19148-3247
Phone (267) 225-7775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190312003152 | PA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 1052651973 |
Receives reassigned benefits from 4 practitioners Practice locations: Philadelphia, PA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548201600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657152000000",
"number": "1154885291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 DALY ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191483247",
"telephone_number": "267-225-7775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4902 ARCH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191392727",
"telephone_number": "267-225-7775"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPTIMAL HOME REHAB, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-23",
"last_updated": "2022-07-07",
"certification_date": "2022-07-07",
"status": "A",
"authorized_official_last_name": "BROADY",
"authorized_official_first_name": "DORIEAN",
"authorized_official_middle_name": "YASMEEN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "267-225-7775",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.