Individual provider Active NPI

Eric Joseph Anderson, PT,DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1396395653
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029971 Issued in PA
Practice address
2350 W Oregon Ave
Philadelphia, PA 19145-4122
Phone
(215) 336-6630
NPI assigned
Sep 18, 2019
Last updated
May 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 044937 NY
Physical Therapist 225100000X 029971 PA Primary

Addresses

Primary practice location

2350 W Oregon Ave
Philadelphia, PA 19145-4122

Mailing address

604 Miller St
Philadelphia, PA 19125-2722
Phone (718) 689-3662

Other practice location 1

1351 Forest Ave
Staten Island, NY 10302-2049
Phone (718) 390-0090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015001951 NY Practitioner - Physical Therapist in Private Practice 5799016200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

1351 Forest Ave
Staten Island, NY 10302-2049
Phone (718) 390-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029971PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Sep 11, 2019 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

900 Route 9 N
Ste 410
Woodbridge, NJ 07095

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

1243 Woodrow Rd
Ste 323
Staten Island, NY 10309
Phone (718) 966-0111

1351 Forest Ave
Staten Island, NY 10302
Phone (718) 390-0060

4079 Richmond Ave
Staten Island, NY 10312
Phone (718) 481-2020

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, 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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1396395653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MILLER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252722",
            "telephone_number": "718-689-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 W OREGON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454122",
            "telephone_number": "215-336-6630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1351 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103022049",
            "country_code": "US",
            "telephone_number": "718-390-0090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIC",
        "middle_name": "JOSEPH",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-18",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044937",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "029971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.