Advanced Physical Therapy & Sports Rehabilitation

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT018210 Issued in PA

Legal business name

ADVANCED PHYSICAL THERAPY & SPORTS REHABILITATION

Practice address

10100 Jamison Ave
JCC Greater NE
Philadelphia, PA 19116-3832

Phone

(267) 968-0381

NPI assigned

Dec 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mikhail Slobodskoi, PT

Title

Manager

Phone

(267) 242-0077

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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.

• Serguei Avakov, PT

  • Physical Therapist
  • Feasterville Trevose, PA
  • NPI 1487666988
  Medicare reassignment NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326108119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 JAMISON AVENUE",
            "address_2": "JCCS GREATER NE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19116",
            "telephone_number": "267-968-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 JAMISON AVE",
            "address_2": "JCC GREATER NE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163832",
            "telephone_number": "267-968-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY & SPORTS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLOBODSKOI",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "267-242-0077",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "PT018210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Home Health Team, Inc
• Advanced Movement and Balance
• Advanced Neurology Associates, PC
• Advanced Nursing Care Inc (ANC HOmeHealth Services)
• Advanced Physical Therapy (Michael Beaudoin)
• Advanced Sonography LLC
• Advanced Spinal Carecenter
• Advanced Spine and Pain of PA, LLC
• Advanced Spine and Pain, LLC (Relievus)
• Advanced Spine Care Associates, PC

• Specialist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.