Individual provider Active NPI

Stephen Mesaros, PTA

  • Physical Therapy Assistant
  • Stroudsburg, PA
National Provider Identifier
1235526914
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA29627 Issued in FL
Practice address
4227 Manor Dr
Stroudsburg, PA 18360-9451
Phone
(570) 992-4172
NPI assigned
Apr 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE010456 PA
Physical Therapy Assistant 225200000X PTA29627 FL Primary

Addresses

Primary practice location

4227 Manor Dr
Stroudsburg, PA 18360-9451

Mailing address

4227 Manor Dr
Stroudsburg, PA 18360-9451
Phone (570) 992-4172

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
PTA29627FLMDPhysical Therapy Assistant
TE010456PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1235526914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 MANOR DR",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609451",
            "telephone_number": "570-992-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 MANOR DR",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609451",
            "telephone_number": "570-992-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESAROS",
        "first_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE010456",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.