Individual provider Active NPI

Jason Thane Hunter, DPT

  • Physical Therapist
  • Moscow, PA
National Provider Identifier
1285133686
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT026710 Issued in PA
Practice address
208 S Main St
Moscow, PA 18444-9135
Phone
(570) 842-8191
Fax
(570) 842-8192
NPI assigned
Feb 12, 2018
Last updated
Feb 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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 PT026710 PA Primary

Addresses

Primary practice location

208 S Main St
Moscow, PA 18444-9135

Mailing address

655 Northern Blvd
South Abington Township, PA 18411-8740
Phone (570) 842-9323

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180228001494 PA Practitioner - Physical Therapist in Private Practice 7416218854 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
Pivot Physical Therapy of Pennsylvania LLCGroup PAC ID 4981971843, 123 clinicians

Practice addresses (Care Compare)

63 Dallas Village Shopping Ctr
Dallas, PA 18612-1231
Phone (570) 310-1881

655 Northern Blvd
South Abington Township, PA 18411-8740
Phone (570) 587-2142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT026710PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist CurrentSince Feb 5, 2018 Accepting new patients
Procare Physical Therapy Inc Physical Therapist Past Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist Past Accepting new patients

Locations

208 S Main St
Moscow, PA 18444
Phone (570) 842-8191

655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142

130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850

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, 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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1285133686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 NORTHERN BLVD",
            "city": "SOUTH ABINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184118740",
            "telephone_number": "570-842-9323",
            "fax_number": "570-842-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S MAIN ST",
            "city": "MOSCOW",
            "state": "PA",
            "postal_code": "184449135",
            "telephone_number": "570-842-8191",
            "fax_number": "570-842-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "JASON",
        "middle_name": "THANE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.