Individual provider Active NPI

Alexa Maria Vatakis, PT

  • Physical Therapist
  • Carnegie, PA
National Provider Identifier
1447910013
Registry record updated Dec 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT030084 Issued in PA
Practice address
148 E Main St
Carnegie, PA 15106-2429
Phone
(412) 276-1016
NPI assigned
Dec 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2021

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 PT030084 PA Primary

Addresses

Primary practice location

148 E Main St
Carnegie, PA 15106-2429

Mailing address

15 Linden Ave
Monessen, PA 15062-1516
Phone (724) 470-5039

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220121001807 PA Practitioner - Physical Therapist in Private Practice 9234521394 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT030084PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Rehabilitation Systems, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Keystone Rehabilitation Systems, Inc. CurrentSince Jan 3, 2022 Accepting new patients
Keystone Rehabilitation Systems, Inc. Current Accepting new patients

Locations

148 E Main St
Carnegie, PA 15106
Phone (412) 276-1016

725 Cherrington Pkwy
Ste 200
Moon Twp, PA 15108
Phone (412) 262-7800

Organizations & group practices 4

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": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640476800000",
    "number": "1447910013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LINDEN AVE",
            "city": "MONESSEN",
            "state": "PA",
            "postal_code": "150621516",
            "telephone_number": "724-470-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 E MAIN ST",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151062429",
            "telephone_number": "412-276-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATAKIS",
        "first_name": "ALEXA",
        "middle_name": "MARIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carnegie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; 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.