Stacey Ilyse Brown, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT022212 Issued in PA

Practice address

890 Lancaster Ave
Devon, PA 19333-2360

Phone

(610) 225-2451

NPI assigned

Oct 22, 2012

Last updated

Dec 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stacey Ilyse Roth Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JMB Therapy Services LLCGroup PAC ID 8628243748, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• JMB Therapy Services LLC

  dba Dynamic Home Therapy

  • Physical Therapist
  • Berwyn, PA
  • NPI 1396028460
  Medicare reassignment Care Compare group NPD
• JMB Therapy Services LLC

  dba Dynamic Neurofit

  • Physical Therapist
  • Devon, PA
  • NPI 1427524016
  NPD

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1417200973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 LANCASTER AVE",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193332360",
            "telephone_number": "610-225-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 LANCASTER AVE",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193332360",
            "telephone_number": "610-225-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STACEY",
        "middle_name": "ILYSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "40QA01467900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "ROTH",
            "middle_name": "ILYSE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Dreyfuss Brennan, LCSW, MSW
• Bright Smiles Kids Dentistry
• Jason Brodo
• Sara E Brown del Pozo, OTR/L
• Badia Brown, RN
• Rachel Brudzinski
• Jessica Bull, ST
• Jill Marie Burns, PT, DPT
• Chris Burritt, D.O.
• Melissa Eileen Butler

• Physical Therapist in Devon, PA
• Providers in Devon, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.