Organization Active NPI

Kreshon Medical Rehabilitation, PC

  • Physical Medicine & Rehabilitation Physician
  • Allison Park, PA
National Provider Identifier
1477029775
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
KRESHON MEDICAL REHABILITATION, PC
Practice address
3113 Canterbury Dr
Allison Park, PA 15101-1528
Phone
(412) 302-3761
NPI assigned
Oct 15, 2018
Last updated
Oct 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Authorized official

Name
James Kreshon, DONPI 1477583920
Title
Owner
Phone
(412) 302-3761

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

3113 Canterbury Dr
Allison Park, PA 15101-1528

Mailing address

3113 Canterbury Dr
Allison Park, PA 15101-1528
Phone (412) 302-3761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190128001162 PA Part B Supplier - Clinic/Group Practice 9739426891 Receives reassigned benefits from 1 practitioner
Practice locations: Allison Park, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1477029775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 CANTERBURY DR",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151011528",
            "telephone_number": "412-302-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 CANTERBURY DR",
            "city": "ALLISON PARK",
            "state": "PA",
            "postal_code": "151011528",
            "telephone_number": "412-302-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRESHON MEDICAL REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "KRESHON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-302-3761",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allison Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.