NPIMap

Organization Active NPI

Cumberland Orthopedic & Spine Physical Therapy, Inc.

  • Physical Therapist
  • Mechanicsburg, PA
National Provider Identifier
1164533303
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CUMBERLAND ORTHOPEDIC & SPINE PHYSICAL THERAPY, INC.
Practice address
6375 Mercury Drive
Suite 100
Mechanicsburg, PA 17050
Phone
(717) 591-3000
Fax
(717) 591-3003
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Mr. Jose A Dominquez, PT
Title
Chief Executive Officer Owner
Phone
(717) 591-3000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X PT007707L PA

Addresses

Primary practice location

6375 Mercury Drive
Suite 100
Mechanicsburg, PA 17050

Mailing address

6375 Mercury Drive
Suite 100
Mechanicsburg, PA 17050
Phone (717) 591-3000

Other identifiers 1

IdentifierTypeStateIssuer
0078126060002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000248 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0143113324 Receives reassigned benefits from 11 practitioners
Practice locations: Mechanicsburg, PA

National Provider Directory

National Provider Directory

Locations

4640 Trindle Rd
Ste 200
Camp Hill, PA 17011
Phone (717) 761-6100

555 Gettysburg Pike
Ste C300
Mechanicsburg, PA 17055
Phone (717) 458-8840

6402 Carlisle Pike
Mechanicsburg, PA 17050
Phone (717) 590-7215

6375 Mercury Dr
Ste 100
Mechanicsburg, PA 17050
Phone (717) 591-3000

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1164533303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6375 MERCURY DRIVE",
            "address_2": "SUITE 100",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17050",
            "telephone_number": "717-591-3000",
            "fax_number": "717-591-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 MERCURY DRIVE",
            "address_2": "SUITE 100",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17050",
            "telephone_number": "717-591-3000",
            "fax_number": "717-591-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND ORTHOPEDIC & SPINE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "DOMINQUEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER OWNER",
        "authorized_official_telephone_number": "717-591-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT007707L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078126060002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.

Verify at the official NPI Registry.