Individual provider Active NPI

Pamela H Bebenroth, PT

  • Physical Therapist
  • Brecksville, OH
National Provider Identifier
1295062370
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001941 Issued in OH
Practice address
8180 Brecksville Rd
Ste 204
Brecksville, OH 44141-1353
Phone
(216) 536-5288
Fax
(216) 264-1079
NPI assigned
Nov 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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 PT001941 OH Primary

Addresses

Primary practice location

8180 Brecksville Rd
Ste 204
Brecksville, OH 44141-1353

Mailing address

8180 Brecksville Rd
Ste 204
Brecksville, OH 44141-1353
Phone (216) 536-5288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190411001153 OH Practitioner - Physical Therapist in Private Practice 7214079938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8180 Brecksville Rd
Suite 204
Brecksville, OH 44141-1353
Phone (216) 536-5288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT001941OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roth PT-CLT Physical Therapist CurrentSince Feb 11, 2019 Accepting new patients
Universal Therapy Dynamics, Inc Past Accepting new patients

Locations

8180 Brecksville Rd
Ste 204
Brecksville, OH 44141
Phone (216) 536-5288

Organizations & group practices 2

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": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1295062370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 BRECKSVILLE RD",
            "address_2": "STE 204",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411353",
            "telephone_number": "216-536-5288",
            "fax_number": "216-264-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 BRECKSVILLE RD",
            "address_2": "STE 204",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411353",
            "telephone_number": "216-536-5288",
            "fax_number": "216-264-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEBENROTH",
        "first_name": "PAMELA",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT001941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brecksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.