Individual provider Active NPI

Thomas Vaccaro, DPT, PT

  • Physical Therapist
  • Montrose, PA
National Provider Identifier
1356156137
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT033073 Issued in PA
Practice address
417 Grow Ave
Montrose, PA 18801-1105
Phone
(570) 278-1101
NPI assigned
Feb 10, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 PT033073 PA Primary

Addresses

Primary practice location

417 Grow Ave
Montrose, PA 18801-1105

Mailing address

81 Jackson St
Montrose, PA 18801-1416
Phone (570) 485-7772

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226002091 PA Practitioner - Physical Therapist in Private Practice 6002336690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pivot Physical Therapy of Pennsylvania LLCGroup PAC ID 4981971843, 123 clinicians

Practice addresses (Care Compare)

417 Grow Ave
Montrose, PA 18801-1105
Phone (570) 278-1101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT033073PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pivot Physical Therapy of Pennsylvania, LLC Physical Therapist CurrentSince Feb 17, 2025 Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist Past Accepting new patients
Procare Physical Therapy Inc Physical Therapist PastSince Feb 17, 2025 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

417 Grow Ave
Montrose, PA 18801
Phone (570) 278-1101

655 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2142

130 W Main St
Ste 100B
Trappe, PA 19426
Phone (484) 471-6850

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1356156137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 JACKSON ST",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188011416",
            "telephone_number": "570-485-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 GROW AVE",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188011105",
            "telephone_number": "570-278-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "THOMAS",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT033073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.