NPIMap

Organization Active NPI

Derek Enterprises LLC

Doing business as Pro Rehabilitiation Services

  • Physical Therapist
  • W Hazleton, PA
National Provider Identifier
1659457158
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DEREK ENTERPRISES LLC
Doing business as
Pro Rehabilitiation Services
Practice address
106 Rotary Drive
Valmont Industrial Park
W Hazleton, PA 18202
Phone
(570) 459-6333
Fax
(570) 459-5255
NPI assigned
Oct 27, 2006
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Mr. Don R Cassetori
Title
Business MGR Treas
Phone
(570) 823-7761

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

106 Rotary Drive
Valmont Industrial Park
W Hazleton, PA 18202

Mailing address

1086 Route 315
Plains, PA 18702
Phone (570) 823-7761

Other identifiers 6

IdentifierTypeStateIssuer
315464OtherPAHEALTH AMERICA HLTH ASSUR
50042164OtherPACAPITAL BCBS
61915OtherPAGEISINGER
1507382OtherPAHIGHMARK BCBS
118707500OtherPAUS DEPT OF LABOR
5234560OtherPAAETNA US HEALTHCARE

Other names 1

  • Pro Rehabilitiation Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231219000023 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1355791252 Receives reassigned benefits from 49 practitioners
Practice locations: West Hazleton, PA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1659457158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 ROUTE 315",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-7761",
            "fax_number": "570-822-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 ROTARY DRIVE",
            "address_2": "VALMONT INDUSTRIAL PARK",
            "city": "W HAZLETON",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-459-6333",
            "fax_number": "570-459-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "CASSETORI",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS MGR TREAS",
        "authorized_official_telephone_number": "570-823-7761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA HLTH ASSUR",
            "identifier": "315464",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BCBS",
            "identifier": "50042164",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "61915",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "1507382",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "118707500",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5234560",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Rehabilitiation Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pro Rehabilitiation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in W Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.