Justin D Eisenhofer, DPT, OCS, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT019473 Issued in PA

Practice address

5479 Pottsville Pike
Suite 200
Leesport, PA 19533-8650

Phone

(610) 926-6778

Fax

(610) 926-7200

NPI assigned

Jul 29, 2006

Last updated

May 27, 2016By the provider in NPPES

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Mountain Physical Therapy LLCGroup PAC ID 4981771631, 12 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Mountain Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Sinking Spring, PA
  • NPI 1932374113
  Medicare reassignment Care Compare group NPD
• Eisenhofer Physical Therapy

  • Physical Therapy Clinic/Center
  • Leesport, PA
  • NPI 1720661127
  NPD Authorized official

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1649284977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 36TH ST",
            "address_2": "SUITE 100",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011005",
            "telephone_number": "304-917-3660",
            "fax_number": "304-917-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5479 POTTSVILLE PIKE",
            "address_2": "SUITE 200",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338650",
            "telephone_number": "610-926-6778",
            "fax_number": "610-926-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHOFER",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "credential": "DPT, OCS, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002261",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT019473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022270250001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003931",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00033898",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2617663",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Easy Does It, Inc.
• Tara Ebling, MA, CFY-SLP
• Vanessa Edwards, M.S., CFY-SLP
• Shannon Egan
• Eisenhofer Physical Therapy
• Every Body Pilates
• Kari Eyer, MA
• Kaitlin Faulcon
• Amy Faust
• Brady Fidler, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.