Individual provider Active NPI

Jennifer L O'Brien, PT

  • Physical Therapist
  • Bensalem, PA
National Provider Identifier
1194834382
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTO-13897L Issued in PA
Practice address
2966 Street Rd
Bensalem, PA 19020-2604
Phone
(215) 639-2639
Fax
(215) 929-2464
NPI assigned
Aug 30, 2006
Last updated
Feb 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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 PTO-13897L PA Primary

Addresses

Primary practice location

2966 Street Rd
Bensalem, PA 19020-2604

Mailing address

2 W 10TH St
Marcus Hook, PA 19061-4513
Phone (610) 859-8850

Other identifiers 2

IdentifierTypeStateIssuer
001123138OtherPAHIGHMARK PABS
0057629000OtherPAIBC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028000838 FL Practitioner - Physical Therapist in Private Practice 6608972054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 W Indiantown Rd
Suite 104
Jupiter, FL 33458-3539
Phone (561) 745-8909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTO-13897LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiocare Inc CurrentSince Aug 16, 2013 Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist Past Accepting new patients
Dynamic Therapy Services of Pennsylvania LLC Physical Therapist Past Accepting new patients

Locations

125 W Indiantown Rd
Ste 104
Jupiter, FL 33458
Phone (561) 745-8909

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1194834382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W 10TH ST",
            "city": "MARCUS HOOK",
            "state": "PA",
            "postal_code": "190614513",
            "telephone_number": "610-859-8850",
            "fax_number": "610-859-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2966 STREET RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202604",
            "telephone_number": "215-639-2639",
            "fax_number": "215-929-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PTO-13897L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PABS",
            "identifier": "001123138",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0057629000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.