Joseph Dattilo, PT, C.PED

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1866 Issued in NH

Practice address

64 Portsmouth Ave
Suite 5
Stratham, NH 03885-2523

Phone

(603) 772-8222

Fax

(603) 772-6738

NPI assigned

Sep 20, 2005

Last updated

May 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NH, MA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Proex Physical Therapy, LLC

  • Physical Therapist
  • Woburn, MA
  • NPI 1831190453

  NH

  Medicare reassignment Care Compare group NPD
• Stratham Physical Therapy

  • Physical Therapist
  • Stratham, NH
  • NPI 1114950318
  Authorized official Same address or phone
• Stratham Physical Therapy

  • Physical Therapy Clinic/Center
  • Epping, NH
  • NPI 1699971259
  Authorized official Same address or phone
• Proex Physical Therapy, LLC

  • Occupational Therapist
  • Boston, MA
  • NPI 1508757956
  NPD
• Competitive Edge Physical Therapy & Sports Training, LLC

  • Physical Therapy Clinic/Center
  • Norwell, MA
  • NPI 1366502023

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1194710756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 COMMERCE WAY",
            "address_2": "STE. 120",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038018200",
            "telephone_number": "603-427-8066",
            "fax_number": "603-501-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 PORTSMOUTH AVE",
            "address_2": "SUITE 5",
            "city": "STRATHAM",
            "state": "NH",
            "postal_code": "038852523",
            "telephone_number": "603-772-8222",
            "fax_number": "603-772-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PT, C.PED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "1866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3820128",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4353867",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "201859513",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08Y008079NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Core Physicians, LLC (Core Endocrinology)
• Mark Covey, MD
• Brienne Danielle Cressey, MD, MBA
• Daniele A Crutcher
• CVS Manchester NH, L.L.C. (CVS Pharmacy #00500)
• Davis Care Group, LLC (Senior Helpers of Southern New Hampshire)
• Diane Dipalermo, MS OTR-L
• Edward Doherty, RPH
• James H Dolan, DPM
• Ellen Doller, MS, OTR-L

• Physical Therapist in Stratham, NH
• Providers in Stratham, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.