Individual provider Active NPI

Judy Wiskoski, P.T.

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1205011947
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006401L Issued in PA
Practice address
12000 Bustleton Ave
Suite 100
Philadelphia, PA 19116-2151
Phone
(215) 677-8870
NPI assigned
Dec 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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 PT006401L PA Primary

Addresses

Primary practice location

12000 Bustleton Ave
Suite 100
Philadelphia, PA 19116-2151

Mailing address

12000 Bustleton Ave
Suite 100
Philadelphia, PA 19116-2151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080214000167 PA Practitioner - Physical Therapist in Private Practice 3072696061 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Dec 30, 2024 Accepting new patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Dec 30, 2024 Accepting new patients
Mark J. Rosen, R.P.T., P.C. Physical Therapist Past Accepting new patients

Locations

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

528 Kimberton Rd
Phoenixville, PA 19460
Phone (610) 933-6232

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1205011947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151",
            "telephone_number": "215-677-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISKOSKI",
        "first_name": "JUDY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT006401L",
            "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 Dec 31, 2007; 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.