Individual provider Active NPI

Nina Dinan, PT

  • Orthopedic Physical Therapist
  • Williston, VT
National Provider Identifier
1487904926
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
040.0086396 Issued in VT
Practice address
426 Industrial Ave Ste 190
Williston, VT 05495-7904
Phone
(802) 860-4360
NPI assigned
Sep 12, 2012
Last updated
Jun 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 040.0086396 VT Primary

Addresses

Primary practice location

426 Industrial Ave Ste 190
Williston, VT 05495-7904

Mailing address

426 Industrial Ave Ste 190
Williston, VT 05495-7904
Phone (802) 860-4360

Other practice location 1

2 Champlain Cmns
Suite 4
Saint Albans, VT 05478-2049
Phone (802) 524-1155

Other identifiers 1

IdentifierTypeStateIssuer
1021043MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121116000026 VT Practitioner - Physical Therapist in Private Practice 4082865258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT 360 IncGroup PAC ID 0749469906, 18 clinicians

Practice addresses (Care Compare)

426 Industrial Ave
Suite 190
Williston, VT 05495-7904
Phone (802) 860-4360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT 360 Inc Orthopedic CurrentSince Jul 23, 2014 Accepting new patients
Rush-Select Holdings, LLC PastSince Jun 1, 2022 Accepting new patients
Choice Physical Therapy of St. Albans, LLC Past Accepting new patients

Locations

426 Industrial Ave
Ste 190
Williston, VT 05495
Phone (802) 657-7990

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1487904926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 INDUSTRIAL AVE STE 190",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957904",
            "telephone_number": "802-860-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 INDUSTRIAL AVE STE 190",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957904",
            "telephone_number": "802-860-4360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Champlain Cmns",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Saint Albans",
            "state": "VT",
            "postal_code": "054782049",
            "country_code": "US",
            "telephone_number": "802-524-1155",
            "fax_number": "802-524-2664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINAN",
        "first_name": "NINA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VT",
            "license": "040.0086396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021043",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.