Individual provider Active NPI

Alyson M Dondorfer, PT

  • Physical Therapist
  • Mentor, OH
National Provider Identifier
1295752871
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 008741 Issued in OH
Practice address
8836 Tyler Blvd
Mentor, OH 44060-4361
Phone
(440) 255-9553
Fax
(440) 255-9563
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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 PT 008741 OH Primary

Addresses

Primary practice location

8836 Tyler Blvd
Mentor, OH 44060-4361

Mailing address

8836 Tyler Blvd
Mentor, OH 44060-4361
Phone (440) 255-9553

Other identifiers 2

IdentifierTypeStateIssuer
2600260MedicaidOH
9350121OtherOHMEDICARE GROUP PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050128000009 OH Practitioner - Physical Therapist in Private Practice 8224088117 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Orthopedic and Spinal TherapyGroup PAC ID 9931592060, 3 clinicians

Practice addresses (Care Compare)

7545 Fredle Dr
Concord Township, OH 44077-9406
Phone (440) 357-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 008741OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Orthopedic and Spinal Therapy CurrentSince Jun 5, 2023 Accepting new patients
Highland Wellness Center Inc. CurrentSince Nov 1, 2021 Accepting new patients
Universal Therapy Dynamics, Inc Past Accepting new patients

Locations

7545 Fredle Dr
Concord Township, OH 44077
Phone (440) 357-1717

5606 Wilson Mills Rd
Highland Heights, OH 44143
Phone (440) 449-1866

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1295752871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8836 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604361",
            "telephone_number": "440-255-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604361",
            "telephone_number": "440-255-9553",
            "fax_number": "440-255-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONDORFER",
        "first_name": "ALYSON",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 008741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2600260",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "9350121",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.