Individual provider Active NPI

Robert Poleshuk, DPT

  • Physical Therapist
  • Doylestown, PA
National Provider Identifier
1568916526
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT025462 Issued in PA
Practice address
73 Old Dublin Pike
Doylestown, PA 18901-2491
Phone
(215) 489-1701
Fax
(215) 489-1705
NPI assigned
Aug 8, 2016
Last updated
Aug 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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 PT025462 PA Primary

Addresses

Primary practice location

73 Old Dublin Pike
Doylestown, PA 18901-2491

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 1

IdentifierTypeStateIssuer
PT025462OtherPASTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160906001069 PA Practitioner - Physical Therapist in Private Practice 1658667415 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parry PT LLCGroup PAC ID 9537556956, 10 clinicians
Willow Grove Physical Therapy LLCGroup PAC ID 0749189256, 22 clinicians

Practice addresses (Care Compare)

723 Route 113
Souderton, PA 18964-1000
Phone (215) 538-1999

875 N Easton Rd
Glenside, PA 19038-5239
Phone (215) 277-5552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT025462PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Grove Physical Therapy, LLC Physical Therapist CurrentSince Oct 29, 2025 Accepting new patients
Parry PT LLC Physical Therapist CurrentSince Mar 4, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 4, 2019 Accepting new patients
JKM Health LLC CurrentSince May 1, 2021 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 4, 2019 Accepting new patients
Parry PT LLC Physical Therapist CurrentSince Mar 4, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

701 Hyde Park
Doylestown, PA 18902
Phone (215) 345-8141

73 Old Dublin Pike
Ste 6
Doylestown, PA 18901
Phone (215) 348-0666

875 N Easton Rd
Glenside, PA 19038
Phone (215) 277-5552

890 Maple Ave
Harleysville, PA 19438
Phone (215) 538-1999

55 N York Rd
Ste 100
Hatboro, PA 19040
Phone (215) 394-5116

1753 Kendarbren Dr
Ste 610
Jamison, PA 18929
Phone (215) 343-2141

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

723 Route 113
Souderton, PA 18964
Phone (215) 538-1999

723 Route 113
Ste 6
Souderton, PA 18964
Phone (215) 538-1999

2325 Maryland Rd
Ste 205
Willow Grove, PA 19090
Phone (215) 659-7759

Organizations & group practices 6

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1568916526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 OLD DUBLIN PIKE",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189012491",
            "telephone_number": "215-489-1701",
            "fax_number": "215-489-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLESHUK",
        "first_name": "ROBERT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT025462",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.