Active NPI
Vasil Dimitrov Dimitrov, PT
- Orthopedic Physical Therapist
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT026119
- Practice address
- 2311 Cottman Ave
Philadelphia, PA 19149-1007 - Phone
- (215) 331-3414
- NPI assigned
- Oct 16, 2017
- Last updated
- Oct 16, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT026119 | PA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physionetics LLC | Orthopedic | Current | Accepting new patients |
| Naples Rehabilitative Services LLC | Orthopedic | Current | Accepting new patients |
| Freedom Physical Therapy and Fitness, PLLC | Orthopedic | Past | 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.
-
- Physical Medicine & Rehabilitation Physician
- Naples, FL
- NPI 1982179222
Orthopedic
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.