Individual provider Active NPI

Paul Vernon Haerling, PT

  • Physical Therapist
  • Havertown, PA
National Provider Identifier
1427365220
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020756 Issued in PA
Practice address
57 W Eagle Rd
Suite 1
Havertown, PA 19083-2234
Phone
(610) 789-9887
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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 PT020756 PA Primary

Addresses

Primary practice location

57 W Eagle Rd
Suite 1
Havertown, PA 19083-2234

Mailing address

57 W Eagle Rd
Suite 1
Havertown, PA 19083-2234
Phone (610) 789-9887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000360 PA Practitioner - Physical Therapist in Private Practice 6709060205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restoration Physical Therapy LLCGroup PAC ID 4284818956, 2 clinicians

Practice addresses (Care Compare)

203 E Baltimore Ave
Suite 2
Media, PA 19063-3433
Phone (610) 565-0670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Physical Therapy LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients

Locations

203 E Baltimore Ave
Ste 2
Media, PA 19063
Phone (610) 565-0670

203 E Baltimore Ave
Media, PA 19063
Phone (610) 565-0670

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1427365220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W EAGLE RD",
            "address_2": "SUITE 1",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832234",
            "telephone_number": "610-789-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W EAGLE RD",
            "address_2": "SUITE 1",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832234",
            "telephone_number": "610-789-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAERLING",
        "first_name": "PAUL",
        "middle_name": "VERNON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.