Active NPI
David Thomas Kisha, PT
- Physical Therapist
- Hamburg, PA
National Provider Identifier
1326008798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012979L
- Practice address
- 16515 Pottsville Pike
Hamburg, PA 19526-8182 - Phone
- (484) 660-3139
- Fax
- (484) 660-3373
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012979L | PA | Primary |
Addresses
Primary practice location
16515 Pottsville Pike
Hamburg, PA 19526-8182
Mailing address
430 Innovation Drive
Blairsville, PA 15717-8096
Phone (724) 343-4060
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 339462 | Other | PA | HIGHMARK BLUE SHIELD |
| 50107119 | Other | PA | CAPITAL BLUE CROSS |
| 1026928760001 | Medicaid | PA | |
| 1326008798 | Other | PA | HEALTH AMERICA/HEALTH ASSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT012979L | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Rehabilitation and Health Services, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Cranberry Township, PA
- NPI 1720084155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1326008798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 INNOVATION DRIVE",
"city": "BLAIRSVILLE",
"state": "PA",
"postal_code": "157178096",
"telephone_number": "724-343-4060",
"fax_number": "724-343-4069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16515 POTTSVILLE PIKE",
"city": "HAMBURG",
"state": "PA",
"postal_code": "195268182",
"telephone_number": "484-660-3139",
"fax_number": "484-660-3373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISHA",
"first_name": "DAVID",
"middle_name": "THOMAS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT012979L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "339462",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50107119",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1026928760001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AMERICA/HEALTH ASSURANCE",
"identifier": "1326008798",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.