Individual provider Active NPI

John Paul Accrocco, PT

  • Physical Therapist
  • Bellbrook, OH
National Provider Identifier
1215073564
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.004448 Issued in OH
Practice address
4403 State Route 725
Suite B
Bellbrook, OH 45305-2700
Phone
(937) 848-8882
NPI assigned
Jan 30, 2007
Last updated
Sep 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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 PT.004448 OH Primary

Addresses

Primary practice location

4403 State Route 725
Suite B
Bellbrook, OH 45305-2700

Mailing address

155 S Tuttle Rd
Springfield, OH 45505-1560
Phone (937) 848-8882

Other identifiers 1

IdentifierTypeStateIssuer
2513515MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000942 OH Practitioner - Physical Therapist in Private Practice 2365418662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Evaluation and Management Center of Ohio IncGroup PAC ID 2365475480, 11 clinicians

Practice addresses (Care Compare)

155 S Tuttle Rd
Springfield, OH 45505-1560
Phone (937) 717-6436

1550 Yankee Park PL
Suite a
Centerville, OH 45458-1838
Phone (937) 439-4949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT.004448OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
KNCC Enterprise, LLC Physical Therapist CurrentSince Jan 1, 2012 Accepting new patients
Pain Evaluation & Management Center of Ohio, Inc. Physical Therapist CurrentSince May 1, 2016 Accepting new patients
KNCC Enterprise, LLC PastSince Jan 1, 2012 Accepting new patients

Locations

Dept L2433
Columbus, OH 43260

1512 Yankee Park Pl
Dayton, OH 45458
Phone (937) 434-0099

1550 Yankee Park Pl
Ste A
Dayton, OH 45458
Phone (937) 439-4949

7774 Dayton Springfield Rd
Ste C
Fairborn, OH 45324
Phone (937) 340-6261

155 S Tuttle Rd
Springfield, OH 45505
Phone (937) 717-6436

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7436/brand/1/csg/1/fhir/r4

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, 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1215073564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S TUTTLE RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455051560",
            "telephone_number": "937-848-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 STATE ROUTE 725",
            "address_2": "SUITE B",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453052700",
            "telephone_number": "937-848-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACCROCCO",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.004448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2513515",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellbrook, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.