NPIMap

Organization Active NPI

La Fortaleza Physical Therapy Center Inc.

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1285673517
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-009127L Issued in PA
Legal business name
LA FORTALEZA PHYSICAL THERAPY CENTER INC.
Practice address
133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone
(215) 455-5370
Fax
(215) 455-5374
NPI assigned
Jun 5, 2006
Last updated
Jun 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Luis G Hincapie, MPTNPI 1134268600
Title
Clinical Director
Phone
(215) 455-5370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT-009127L PA Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X PT-009127L PA

Addresses

Primary practice location

133 W Hunting Park Ave
Philadelphia, PA 19140-2717

Mailing address

133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone (215) 455-5370

Other identifiers 1

IdentifierTypeStateIssuer
0017400900003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110104000456 PA Part B Supplier - Clinic/Group Practice 5395934590 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Philadelphia, PA
O20230804003657 PA DME Supplier - Independently-Practicing Physical Therapist 5395934590 Practice locations: Philadelphia, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
La Fortaleza P T Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1285673517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402717",
            "telephone_number": "215-455-5370",
            "fax_number": "215-455-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402717",
            "telephone_number": "215-455-5370",
            "fax_number": "215-455-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FORTALEZA PHYSICAL THERAPY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "HINCAPIE",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "215-455-5370",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-009127L",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "PT-009127L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017400900003",
            "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 Jun 9, 2016; 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.