Individual provider Active NPI

Alexis Neilson, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1245558386
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020265 Issued in PA
Practice address
2401 Pennsylvania Ave.
Ste. 1D5
Philadelphia, PA 19130
Phone
(215) 236-3466
NPI assigned
May 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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 PT020265 PA Primary

Addresses

Primary practice location

2401 Pennsylvania Ave.
Ste. 1D5
Philadelphia, PA 19130

Mailing address

919 Morris St
Philadelphia, PA 19148-1111

Other identifiers 1

IdentifierTypeStateIssuer
PT020265OtherPAPHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024000599 PA Practitioner - Physical Therapist in Private Practice 2961755723 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Mar 23, 2023 Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Physical Therapist Current Accepting new patients
Reconstructive Orthopaedic Associates II LLC Physical Therapist CurrentSince Oct 16, 2018 Accepting new patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Mar 23, 2023 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Oct 16, 2018 Accepting new patients

Locations

352 Railroad St
Ligonier, PA 15658
Phone (724) 238-3301

2175 McClellandtown Rd
Ste Ab
Masontown, PA 15461
Phone (724) 491-5220

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Organizations & group practices 5

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": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1245558386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 MORRIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 PENNSYLVANIA AVE.",
            "address_2": "STE. 1D5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19130",
            "telephone_number": "215-236-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSON",
        "first_name": "ALEXIS",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT020265",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.