Individual provider Active NPI

Walt Dalessandris, PT

  • Physical Therapist
  • Media, PA
National Provider Identifier
1225004971
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012393L Issued in PA
Practice address
5201 Pennell Rd
Media, PA 19063-6502
Phone
(610) 874-9710
Fax
(610) 874-9723
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT012393L PA Primary

Addresses

Primary practice location

5201 Pennell Rd
Media, PA 19063-6502

Mailing address

3809 W Chester Pike Ste 150
Newtown Square, PA 19073-0259
Phone (610) 359-5640

Other practice location 1

One Medical Center Blvd, CCMC
Pob II, Suite 320
Upland, PA 19013
Phone (610) 874-9710

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111111000313 PA Practitioner - Physical Therapist in Private Practice 8325251812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Orthopaedic and Sports Medicine Associates, LTDGroup PAC ID 5890681092, 218 clinicians

Practice addresses (Care Compare)

2004 Sproul Rd
FL 1
Broomall, PA 19008-3511
Phone (610) 353-0800

5201 Pennell Rd
Media, PA 19063-6502

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Orthopaedic and Sports Medicine Associates, LTD Physical Therapist CurrentSince Nov 1, 2000 Accepting new patients
Premier Orthopaedic and Sports Medicine Associates LTD Physical Therapist CurrentSince Nov 1, 2000 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients

Locations

2004 Sproul Rd
Fl 1
Broomall, PA 19008
Phone (610) 353-0800

2004 Sproul Rd
Ste 100
Broomall, PA 19008
Phone (610) 353-0800

1 Medical Center Blvd
Ste 320
Chester, PA 19013
Phone (610) 874-9710

5201 Pennell Rd
Ste B
Media, PA 19063
Phone (484) 440-9349

5201 Pennell Rd
Media, PA 19063
Phone (610) 874-9710

3809 West Chester Pike
Ste 150
Newtown Square, PA 19073
Phone (484) 356-9401

Interoperability endpoints

  • Direct secure messaging: walt.d.alessandris.1@22724.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225004971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 W CHESTER PIKE STE 150",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190730259",
            "telephone_number": "610-359-5640",
            "fax_number": "610-359-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 PENNELL RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190636502",
            "telephone_number": "610-874-9710",
            "fax_number": "610-874-9723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "ONE MEDICAL CENTER BLVD, CCMC",
            "address_2": "POB II, SUITE 320",
            "address_purpose": "LOCATION",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "19013",
            "country_code": "US",
            "telephone_number": "610-874-9710",
            "fax_number": "610-874-9723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALESSANDRIS",
        "first_name": "WALT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT012393L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.