Individual provider Active NPI

Sebastian Konefal

  • Physical Therapy Assistant
  • Stroudsburg, PA
National Provider Identifier
1467138719
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE012745 Issued in PA
Practice address
370 Whitestone Cor
Stroudsburg, PA 18360-7193
Phone
(570) 476-1600
NPI assigned
Jun 22, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE012745 PA Primary

Addresses

Primary practice location

370 Whitestone Cor
Stroudsburg, PA 18360-7193

Mailing address

115 Erica Way
Stroudsburg, PA 18360-7967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TE012745PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1467138719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ERICA WAY",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 WHITESTONE COR",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607193",
            "telephone_number": "570-476-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONEFAL",
        "first_name": "SEBASTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE012745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.