Lauren V Di Domenico, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT026506 Issued in PA

Practice address

5201 Pennell Rd
Media, PA 19063-6502

Phone

(610) 874-9710

Fax

(610) 874-9723

NPI assigned

Dec 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Move Well LLCGroup PAC ID 5294068516, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Move Well LLC

  • Physical Therapy Clinic/Center
  • Swarthmore, PA
  • NPI 1376106146

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1588170948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 W CHESTER PIKE STE 150",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190730259",
            "telephone_number": "610-359-5640",
            "fax_number": "610-359-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 PENNELL RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190636502",
            "telephone_number": "610-874-9710",
            "fax_number": "610-874-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI DOMENICO",
        "first_name": "LAUREN",
        "middle_name": "V",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy James Desmarais, PA-C
• Jennifer Deutsch, M.S.CCC-SLP
• Elizabeth M Devenney
• Devereux Foundation Yearsley
• Ryane Michele Devlin, PTA
• Aissatou Diallo, RBT
• Rachel Diamond, LCSW
• Anier Diaz Vidal, DMD
• Caroline Dickerson, M.S., CCC-SLP
• Beth Dienno, P.T.A.

• Physical Therapist in Media, PA
• Providers in Media, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.