Individual provider Active NPI

Maryanne Cardelli, PT

  • Physical Therapist
  • Trevose, PA
National Provider Identifier
1578760104
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006337L Issued in PA
Practice address
339- East Street Road
Trevose, PA 19053
Phone
(267) 574-8110
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT006337L PA Primary

Addresses

Primary practice location

339- East Street Road
Trevose, PA 19053

Mailing address

3565 Post Rd
Huntingdon Valley, PA 19006-3240
Phone (215) 880-9625

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT006337LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Medical and Diagnostic, PC PastSince Jan 1, 2016 Accepting new patients
Health Source Rehabilitation Inc Past Accepting new patients
David Trumbore, PT, DPT, PC Physical Therapist PastSince Feb 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: maryanne.cardelli.1@14940.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578760104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 POST RD",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190063240",
            "telephone_number": "215-880-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339- EAST STREET ROAD",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "19053",
            "telephone_number": "267-574-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDELLI",
        "first_name": "MARYANNE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT006337L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trevose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.