Active NPI
Lisa Diefenbach, PT
- Physical Therapist
- Ebensburg, PA
National Provider Identifier
1225190812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT002640E
- Practice address
- 3053 New Germany Rd
Ebensburg, PA 15931-3516 - Phone
- (800) 332-5740
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT002640E | PA | Primary |
Addresses
Primary practice location
3053 New Germany Rd
Ebensburg, PA 15931-3516
Mailing address
855 Forest Ave
Bellefonte, PA 16823-8215
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 624203 | Other | PA | HIGHMARK |
| 1536333 | Other | PA | GATEWAY HEALTH PLANS |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225190812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 FOREST AVE",
"city": "BELLEFONTE",
"state": "PA",
"postal_code": "168238215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3053 NEW GERMANY RD",
"city": "EBENSBURG",
"state": "PA",
"postal_code": "159313516",
"telephone_number": "800-332-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEFENBACH",
"first_name": "LISA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT002640E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "624203",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY HEALTH PLANS",
"identifier": "1536333",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ebensburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.