Individual provider Active NPI

Jeremy Matthew Baronner, DPT

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1649140310
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT033791 Issued in PA
Practice address
3425 Peach St
Erie, PA 16508-2779
Phone
(814) 864-4100
Fax
(814) 866-1811
NPI assigned
Nov 7, 2025
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT033791 PA Primary

Addresses

Primary practice location

3425 Peach St
Erie, PA 16508-2779

Mailing address

3425 Peach St
Erie, PA 16508-2779
Phone (814) 864-4100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251205004198 PA Practitioner - Physical Therapist in Private Practice 0345733432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activecare Physical TherapyGroup PAC ID 3971763012, 3 clinicians

Practice addresses (Care Compare)

3425 Peach St
Erie, PA 16508-2779
Phone (814) 864-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT033791PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activecare Physical Therapy Physical Therapist CurrentSince Nov 15, 2025 Accepting new patients

Locations

3425 Peach St
Erie, PA 16508
Phone (814) 450-5463

Organizations & group practices 1

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": "1762473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1649140310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082779",
            "telephone_number": "814-864-4100",
            "fax_number": "814-866-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082779",
            "telephone_number": "814-864-4100",
            "fax_number": "814-866-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARONNER",
        "first_name": "JEREMY",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT033791",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 7, 2025; 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.