Individual provider Active NPI

Lyn Meredith Dufresne, PT

  • Physical Therapist
  • West Chester, PA
National Provider Identifier
1326057506
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016267 Issued in PA
Practice address
613 Cricklewood Rd
West Chester, PA 19382-8507
Phone
(484) 266-0387
Fax
(717) 692-5464
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT016267 PA
Physical Therapist 225100000X PT016267 PA Primary

Addresses

Primary practice location

613 Cricklewood Rd
West Chester, PA 19382-8507

Mailing address

613 Cricklewood Rd
West Chester, PA 19382-8507
Phone (484) 266-0387

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170313000248 PA Practitioner - Physical Therapist in Private Practice 5193009157 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016267PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab1 LLC Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients

Locations

263 Glen Riddle Rd
Media, PA 19063
Phone (610) 358-9933

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1326057506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 CRICKLEWOOD RD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193828507",
            "telephone_number": "484-266-0387",
            "fax_number": "717-692-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 CRICKLEWOOD RD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193828507",
            "telephone_number": "484-266-0387",
            "fax_number": "717-692-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFRESNE",
        "first_name": "LYN",
        "middle_name": "MEREDITH",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "PA",
            "license": "PT016267",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.