Justin James Depermentier, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT024201 Issued in PA

Practice address

450 Park Way
Suite a
Broomall, PA 19008-4202

Phone

(610) 355-1780

Fax

(484) 428-3813

NPI assigned

Mar 12, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Curran Physical Therapy

  • Orthopedic Physical Therapist
  • Havertown, PA
  • NPI 1669806303
  NPD

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1629461868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PARK WAY",
            "address_2": "SUITE 300",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084202",
            "telephone_number": "484-422-8080",
            "fax_number": "484-422-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PARK WAY",
            "address_2": "SUITE A",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190084202",
            "telephone_number": "610-355-1780",
            "fax_number": "484-428-3813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPERMENTIER",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-12",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.022242",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna L Delfin, DO
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• Scott Denoro Jr.
• Monica Depaolo
• Rachel Devine, PTA
• Reagan Halligan Devine, FNP-BC
• Theresa Marie Devine, D.D.S.
• Natalie Marie Dezii
• Manpreet Kaur Dhanota, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.