Individual provider Active NPI

David Matthew Brewer, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1275858128
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTO-20454 Issued in PA
Practice address
7618 Ogontz Ave
Philadelphia, PA 19150-1817
Phone
(267) 323-2778
Fax
(267) 323-2774
NPI assigned
Apr 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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 PTO-20454 PA Primary

Addresses

Primary practice location

7618 Ogontz Ave
Philadelphia, PA 19150-1817

Mailing address

3131 College Heights Blvd
Ste 2400
Allentown, PA 18104-4817
Phone (610) 432-7733

Other identifiers 5

IdentifierTypeStateIssuer
2156631OtherPAHIGHMARK PA BLUE SHIELD
30078791OtherPAKEYSTONE MERCY
306073OtherUNISON
102448115-001MedicaidPA
3777092000OtherPAINDEPENDENCE BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100713000443 PA Practitioner - Physical Therapist in Private Practice 8224160171 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTO-20454PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Priority Physical Therapy LLC Physical Therapist CurrentSince Jun 1, 2015 Accepting new patients
Progress Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

3131 College Heights Blvd
Ste 2400
Allentown, PA 18104
Phone (610) 432-2242

Organizations & group practices 3

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1275858128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "STE 2400",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044817",
            "telephone_number": "610-432-7733",
            "fax_number": "610-432-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7618 OGONTZ AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501817",
            "telephone_number": "267-323-2778",
            "fax_number": "267-323-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "DAVID",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PTO-20454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PA BLUE SHIELD",
            "identifier": "2156631",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30078791",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "306073",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102448115-001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "3777092000",
            "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 Aug 31, 2017; 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.