Individual provider Active NPI

Troy Staker, DPT

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1235915281
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0014745 Issued in DE
Practice address
3567 Silverside Rd
Wilmington, DE 19810-4903
Phone
(302) 529-1911
NPI assigned
Sep 6, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 J1-0014745 DE Primary

Addresses

Primary practice location

3567 Silverside Rd
Wilmington, DE 19810-4903

Mailing address

17 Hurst Rd
Wilmington, DE 19803-3716
Phone (302) 757-0491

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106001027 DE Practitioner - Physical Therapist in Private Practice 8921455445 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0014745DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Hen Physical Therapy, Inc. CurrentSince Sep 16, 2023 Accepting new patients
Blue Hen Physical Therapy, Inc. Current Accepting new patients
Blue Hen Physical Therapy, Inc. CurrentSince Sep 16, 2023 Accepting new patients
Rehabclinics SPT Inc Physical Therapist CurrentSince Jan 7, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Sep 16, 2023 Accepting new patients
Physiotherapy Associates, Inc. CurrentSince Sep 16, 2023 Accepting new patients
Rehabclinics SPT, Inc. PastSince Sep 10, 2023 Accepting new patients

Locations

256 Foxhunt Dr
Bear, DE 19701
Phone (302) 834-8650

320 Grove Ln
Newark, DE 19711
Phone (302) 565-2244

425 New London Rd
Newark, DE 19711
Phone (302) 453-1588

2401 Pennsylvania Ave
Ste 111
Wilmington, DE 19806
Phone (302) 655-5877

2401 Pennsylvania Ave
Ste 112
Wilmington, DE 19806
Phone (302) 655-5877

3567 Silverside Rd
Wilmington, DE 19810
Phone (302) 453-1588

Organizations & group practices 7

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1235915281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HURST RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033716",
            "telephone_number": "302-757-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3567 SILVERSIDE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104903",
            "telephone_number": "302-529-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKER",
        "first_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0014745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.