Individual provider Active NPI

Jan Eiko Ikeda Grove, DPT

  • Physical Therapist
  • Hershey, PA
National Provider Identifier
1255856233
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT026201 Issued in PA
Practice address
250 W Chocolate Ave Ste 3
Hershey, PA 17033-1568
Phone
(717) 547-9100
Fax
(717) 547-9101
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PT026201 PA Primary

Addresses

Primary practice location

250 W Chocolate Ave Ste 3
Hershey, PA 17033-1568

Mailing address

5425 Jonestown Rd Ste 100
Harrisburg, PA 17112-4086
Phone (717) 901-6245

Other practice location 1

5425 Jonestown Road
Suite 100
Harrisburg, PA 17112
Phone (717) 901-6245

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171012000745 PA Practitioner - Physical Therapist in Private Practice 6507131844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madden and Gilbert Physical Therapy LPGroup PAC ID 4587051537, 25 clinicians

Practice addresses (Care Compare)

250 W Chocolate Ave
Suite 3
Hershey, PA 17033-1568
Phone (717) 547-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Madden and Gilbert Physical Therapy LP Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients

Locations

1104 Carlisle Rd
Ste 170
Camp Hill, PA 17011
Phone (717) 210-5676

722 Allegheny St
Ste 2
Dauphin, PA 17018
Phone (717) 474-8754

5425 Jonestown Rd
Ste 100
Harrisburg, PA 17112
Phone (717) 901-6487

250 W Chocolate Ave
Ste 3
Hershey, PA 17033
Phone (717) 547-9100

5103 Carlisle Pike
Mechanicsburg, PA 17050
Phone (717) 591-0955

14625 Mount Airy Rd
Ste 103
Shrewsbury, PA 17361
Phone (717) 584-8744

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255856233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 JONESTOWN RD STE 100",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171124086",
            "telephone_number": "717-901-6245",
            "fax_number": "717-901-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W CHOCOLATE AVE STE 3",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170331568",
            "telephone_number": "717-547-9100",
            "fax_number": "717-547-9101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5425 Jonestown Road",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "17112",
            "country_code": "US",
            "telephone_number": "717-901-6245",
            "fax_number": "717-901-9488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVE",
        "first_name": "JAN",
        "middle_name": "EIKO IKEDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.