Individual provider Active NPI

John Nellett, PT, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1629742044
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029957 Issued in PA
Practice address
800 N Delaware Ave
Philadelphia, PA 19123-3181
Phone
(267) 519-3328
Fax
(267) 519-0547
NPI assigned
Aug 9, 2021
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02024700 NJ
Physical Therapist 225100000X PT029957 PA Primary

Addresses

Primary practice location

800 N Delaware Ave
Philadelphia, PA 19123-3181

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

1165 N Tuckahoe Rd
Williamstown, NJ 08094-3459
Phone (856) 237-7467

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220505000055 PA Practitioner - Physical Therapist in Private Practice 5698171346 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy LLCGroup PAC ID 1951530849, 430 clinicians

Practice addresses (Care Compare)

1930 S Broad St
Philadelphia, PA 19145-2328
Phone (267) 996-3900

3300 Grant Ave
Suite 19C
Philadelphia, PA 19114-2632
Phone (215) 851-1661

3400 Aramingo Ave
Suite 11
Philadelphia, PA 19134-4531
Phone (215) 203-1930

3400 Lancaster Ave
Philadelphia, PA 19104-4964
Phone (215) 662-0397

800 N Delaware Ave
Philadelphia, PA 19123-3181
Phone (267) 519-3328

8015 Frankford Ave
Philadelphia, PA 19136-2736
Phone (215) 338-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT029957PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Jan 13, 2022 Accepting new patients
John Nellett Physical Therapist CurrentSince Mar 27, 2024 Accepting new patients
Pennsylvania Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 12, 2023 Accepting new patients
Elp Nutrition CurrentSince Jan 28, 2024 Accepting new patients

Locations

1165 N Tuckahoe Rd
Williamstown, NJ 08094
Phone (856) 237-7467

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

300 Welsh Rd
Bldg 1
Horsham, PA 19044

Organizations & group practices 4

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": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1629742044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N DELAWARE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233181",
            "telephone_number": "267-519-3328",
            "fax_number": "267-519-0547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 N Tuckahoe Rd",
            "address_purpose": "LOCATION",
            "city": "Williamstown",
            "state": "NJ",
            "postal_code": "080943459",
            "country_code": "US",
            "telephone_number": "856-237-7467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELLETT",
        "first_name": "JOHN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-09",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02024700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029957",
            "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 Apr 13, 2022; 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.