NPIMap

Organization Active NPI

Rise Up Physical Therapy, LLC

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1609364165
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT026046 Issued in PA
Legal business name
RISE UP PHYSICAL THERAPY, LLC
Practice address
4801 Peach St Ste 8
Erie, PA 16509-2044
Phone
(781) 603-9777
NPI assigned
Apr 30, 2018
Last updated
Apr 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Authorized official

Name
Jennifer M Doyle, DPT
Title
Owner
Phone
(781) 603-9777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT026046 PA Primary

Addresses

Primary practice location

4801 Peach St Ste 8
Erie, PA 16509-2044

Mailing address

4801 Peach St Ste 8
Erie, PA 16509-2044
Phone (781) 603-9777

Other identifiers 1

IdentifierTypeStateIssuer
1255617486MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210210000463 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7810302593 Receives reassigned benefits from 9 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

2307 W 12th St
Erie, PA 16505
Phone (814) 528-5667

2311 W 15th St
Erie, PA 16505
Phone (814) 528-5667

4801 Peach St
Ste 8
Erie, PA 16509
Phone (814) 528-5667

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1609364165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 PEACH ST STE 8",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092044",
            "telephone_number": "781-603-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 PEACH ST STE 8",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092044",
            "telephone_number": "781-603-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE UP PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-603-9777",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT026046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255617486",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.