Individual provider Active NPI

Timothy Robert Dusch, PT

  • Student in an Organized Health Care Education/Training Program
  • Danville, PA
National Provider Identifier
1235649351
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 N Academy Ave # 21-30
Danville, PA 17822-4302
Phone
(570) 214-5605
NPI assigned
Oct 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8811 SC
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

100 N Academy Ave # 21-30
Danville, PA 17822-4302

Mailing address

100 N Academy Ave # 21-30
Danville, PA 17822-9800
Phone (570) 214-5605

Other practice location 1

610 W Palmetto St
Florence, SC 29501-4302
Phone (843) 407-0377

Other practice location 2

148 Sauls St Ste B
Lake City, SC 29560-2677
Phone (843) 374-0185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240706000062 PA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 9537426267

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical University of South Carolina College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8811SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ih3 Physcial Therapy Physical Therapist PastSince Jun 14, 2010 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": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1235649351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE # 21-30",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-214-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE # 21-30",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224302",
            "telephone_number": "570-214-5605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 W Palmetto St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295014302",
            "country_code": "US",
            "telephone_number": "843-407-0377",
            "fax_number": "843-799-1944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "148 Sauls St Ste B",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "SC",
            "postal_code": "295602677",
            "country_code": "US",
            "telephone_number": "843-374-0185",
            "fax_number": "843-374-0189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUSCH",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8811",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.