Individual provider Active NPI

Armand W Dethomas Jr., DPT

  • Physical Therapist
  • Glassboro, NJ
National Provider Identifier
1457420440
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021695 Issued in PA
Practice address
707 N Main St
Glassboro, NJ 08028-1605
Phone
(856) 307-9700
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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 40QA01224300 NJ
Physical Therapist 225100000X PT021695 PA Primary

Addresses

Primary practice location

707 N Main St
Glassboro, NJ 08028-1605

Mailing address

115 Main St
Cedarville, NJ 08311-2535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170814000048 PA Practitioner - Physical Therapist in Private Practice 1355612110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Manor Dr
Chalfont, PA 18914-2203
Phone (215) 830-8700

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
79.04
Promoting interoperability
99
Improvement activities
40
Cost
82.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01224300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jul 15, 2017 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Physical Therapist CurrentSince Jul 15, 2017 Accepting new patients

Locations

510 Township Line Rd
Ste 110
Blue Bell, PA 19422
Phone (900) 321-9999

1200 Manor Dr
Chalfont, PA 18914
Phone (215) 830-8700

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

833 Chestnut St
Ste 1402
Philadelphia, PA 19107
Phone (267) 339-3543

Organizations & group practices 2

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1457420440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "city": "CEDARVILLE",
            "state": "NJ",
            "postal_code": "083112535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N MAIN ST",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281605",
            "telephone_number": "856-307-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETHOMAS",
        "first_name": "ARMAND",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01224300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT021695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.