NPIMap

Organization Active NPI

Somerton Industrial Medicine & Rehabilitation, Inc

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1518244565
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002807L Issued in PA
Legal business name
SOMERTON INDUSTRIAL MEDICINE & REHABILITATION, INC
Practice address
12000 Bustleton Ave
Suite 100
Philadelphia, PA 19116-2151
Phone
(215) 677-8870
Fax
(215) 673-9825
NPI assigned
Nov 4, 2011
Last updated
Nov 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Mr. Mark Joel Rosen, P.T.NPI 1841248192
Title
Owner
Phone
(215) 677-8870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT002807L PA Primary

Addresses

Primary practice location

12000 Bustleton Ave
Suite 100
Philadelphia, PA 19116-2151

Mailing address

12000 Bustleton Ave
Suite 100
Philadelphia, PA 19116-2151
Phone (215) 677-8870

Other identifiers 1

IdentifierTypeStateIssuer
N0005291342OtherPAAETNA

National Provider Directory

National Provider Directory

Locations

12000 Bustleton Ave
Ste 100
Philadelphia, PA 19116
Phone (215) 677-8870

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": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1518244565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151",
            "telephone_number": "215-677-8870",
            "fax_number": "215-673-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 100",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151",
            "telephone_number": "215-677-8870",
            "fax_number": "215-673-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERTON INDUSTRIAL MEDICINE & REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-677-8870",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT002807L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "N0005291342",
            "state": "PA"
        }
    ],
    "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 Nov 4, 2011; 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.