Active NPI
Richard Thomas Siperko, MPT
- Physical Therapist
- Wilkes Barre, PA
National Provider Identifier
1649391228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012127L
- Practice address
- 1546 Highway 315
Wilkes Barre, PA 18702-7005 - Phone
- (570) 819-5650
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012127L | PA | Primary |
Addresses
Primary practice location
1546 Highway 315
Wilkes Barre, PA 18702-7005
Mailing address
54 Krych St
Kingston, PA 18704-2605
Phone (570) 714-5128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT012127L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649391228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 KRYCH ST",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187042605",
"telephone_number": "570-714-5128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1546 HIGHWAY 315",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187027005",
"telephone_number": "570-819-5650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIPERKO",
"first_name": "RICHARD",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT012127L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.