Individual provider Active NPI

Guido Candelore, P.T.

  • Physical Therapist
  • Monongahela, PA
National Provider Identifier
1205864014
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008237L Issued in PA
Practice address
1027 Country Club Rd
Monongahela, PA 15063-1553
Phone
(724) 258-6211
Fax
(724) 258-6225
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 PT008237L PA Primary

Addresses

Primary practice location

1027 Country Club Rd
Monongahela, PA 15063-1553

Mailing address

1027 Country Club Rd
Monongahela, PA 15063-1553
Phone (724) 258-6211

Other identifiers 1

IdentifierTypeStateIssuer
0016749970001MedicaidPA

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

LicenseStateTypeSpecialty
PT008237LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Outpatient Rehabilitation Past Accepting new patients

Organizations & group practices 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205864014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631553",
            "telephone_number": "724-258-6211",
            "fax_number": "724-258-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 COUNTRY CLUB RD",
            "city": "MONONGAHELA",
            "state": "PA",
            "postal_code": "150631553",
            "telephone_number": "724-258-6211",
            "fax_number": "724-258-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELORE",
        "first_name": "GUIDO",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT008237L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016749970001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monongahela, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.