NPIMap

Organization Active NPI

La Fortaleza Physical Therapy Center Inc

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1457897779
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-009127L Issued in PA
Legal business name
LA FORTALEZA PHYSICAL THERAPY CENTER INC
Practice address
7500 Central Ave
Physician Building, Ste 102
Philadelphia, PA 19111-2430
Phone
(267) 388-6077
Fax
(215) 638-5007
NPI assigned
Jan 10, 2017
Organization subpart
Yes
Parent organization
LA FORTALEZA PHYSICAL THERAPY CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Authorized official

Name
Luis Hincapie, PTNPI 1134268600
Title
Director
Phone
(215) 455-5370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT-009127L PA Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X PT-009127L PA

Addresses

Primary practice location

7500 Central Ave
Physician Building, Ste 102
Philadelphia, PA 19111-2430

Mailing address

133 W Hunting Park Ave
Philadelphia, PA 19140-2717
Phone (215) 455-5370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110104000456 PA Part B Supplier - Clinic/Group Practice 5395934590 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Philadelphia, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
La Fortaleza Physical Therapy Center Inc4 organizations share this tax ID, including this one
Part of
La Fortaleza Physical Therapy Center Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7500 Central Ave
Ste 102
Philadelphia, PA 19111
Phone (267) 388-6077

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1457897779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191402717",
            "telephone_number": "215-455-5370",
            "fax_number": "215-455-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CENTRAL AVE",
            "address_2": "PHYSICIAN BUILDING, STE 102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112430",
            "telephone_number": "267-388-6077",
            "fax_number": "215-638-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FORTALEZA PHYSICAL THERAPY CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA FORTALEZA PHYSICAL THERAPY CENTER INC",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "HINCAPIE",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "215-455-5370",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-009127L",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "PT-009127L",
            "primary": false
        }
    ],
    "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 Jan 10, 2017; 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.