Individual provider Active NPI

Vasil Dimitrov Dimitrov, PT

  • Orthopedic Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1609387737
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT026119 Issued in PA
Practice address
2311 Cottman Ave
Philadelphia, PA 19149-1007
Phone
(215) 331-3414
NPI assigned
Oct 16, 2017
Last updated
Oct 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT026119 PA Primary

Addresses

Primary practice location

2311 Cottman Ave
Philadelphia, PA 19149-1007

Mailing address

10905 Nandina CT FL 1
Philadelphia, PA 19116-3109
Phone (773) 675-0523

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190315000146 FL Practitioner - Physical Therapist in Private Practice 0345580023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naples Rehabilitative Services LLCGroup PAC ID 0547508517, 2 clinicians

Practice addresses (Care Compare)

400 Vineyards Blvd
Naples, FL 34119-4701
Phone (239) 353-6161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT026119PAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physionetics LLC Orthopedic CurrentSince Feb 28, 2019 Accepting new patients
Naples Rehabilitative Services LLC Orthopedic CurrentSince Nov 2, 2020 Accepting new patients
Freedom Physical Therapy and Fitness, PLLC Orthopedic PastSince Oct 2, 2023 Accepting new patients

Locations

1575 Pine Ridge Rd
Ste 15
Naples, FL 34109
Phone (239) 593-4348

1575 Pine Ridge Rd
Ste 4
Naples, FL 34109
Phone (239) 438-1194

400 Vineyards Blvd
Naples, FL 34119
Phone (239) 353-1650

406 Vineyards Blvd
Naples, FL 34119
Phone (239) 353-6161

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, 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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1609387737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10905 NANDINA CT FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163109",
            "telephone_number": "773-675-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491007",
            "telephone_number": "215-331-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITROV",
        "first_name": "VASIL",
        "middle_name": "DIMITROV",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT026119",
            "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 Oct 16, 2017; 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.