Individual provider Active NPI

Alex Skacel, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1558730010
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT024579 Issued in PA
Practice address
1200 Constitution Ave
Philadelphia, PA 19112-1329
Phone
(267) 592-3190
Fax
(215) 468-1850
NPI assigned
Sep 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT024579 PA Primary

Addresses

Primary practice location

1200 Constitution Ave
Philadelphia, PA 19112-1329

Mailing address

1200 Constitution Ave
Philadelphia, PA 19112-1329
Phone (267) 592-3190

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
PT024579PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1558730010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CONSTITUTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121329",
            "telephone_number": "267-592-3190",
            "fax_number": "215-468-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CONSTITUTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121329",
            "telephone_number": "267-592-3190",
            "fax_number": "215-468-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKACEL",
        "first_name": "ALEX",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024579",
            "primary": true
        }
    ],
    "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 Sep 15, 2015; 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.