Active NPI
Joseph P Derea, PT
- Physical Therapist
- Macungie, PA
National Provider Identifier
1184950750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT008687E
- Practice address
- 175 W Main St
Macungie, PA 18062-1166 - Phone
- (610) 966-6773
- NPI assigned
- Nov 2, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT008687E | PA | Primary |
Addresses
Primary practice location
175 W Main St
Macungie, PA 18062-1166
Mailing address
4563 S 5TH St
Emmaus, PA 18049-4542
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT008687E | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257120000000",
"number": "1184950750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4563 S 5TH ST",
"city": "EMMAUS",
"state": "PA",
"postal_code": "180494542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 W MAIN ST",
"city": "MACUNGIE",
"state": "PA",
"postal_code": "180621166",
"telephone_number": "610-966-6773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEREA",
"first_name": "JOSEPH",
"middle_name": "P",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-02",
"last_updated": "2009-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT008687E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macungie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.