Richard J Cipoletti, D.P.T

Individual provider Active NPI Physical Therapist · Dallas, PA

NPI 1659601573 · NPPES record last updated Jun 28, 2018

Key facts

NPI
1659601573
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT021576 (PA)
Practice address
5 Jacquelyn LN
Dallas, PA 18612-9107
Phone
(631) 223-6713
NPI assigned
Dec 29, 2009
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cip Rehabilitation Inc (46 clinicians)

Practice addresses (Care Compare)

64 Ridgway Dr
Suite 1
Dallas, PA 18612-9263
Phone (570) 255-4578

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180801002902 PA Practitioner - Physical Therapist in Private Practice 4688922016 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT021576PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cip Rehabilitation Inc Physical Therapist Current
since May 9, 2018
Accepting new patients

Locations

64 Ridgway Dr
#1
Dallas, PA 18612
Phone (570) 255-4578

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021576 PA Yes

Addresses

Primary practice location

5 Jacquelyn LN
Dallas, PA 18612-9107

Mailing address

5 Jacquelyn LN
Dallas, PA 18612-9107
Phone (631) 223-6713

Other identifiers

IdentifierTypeStateIssuer
PT021576OtherPAPHYSICAL THERAPIST

Other providers in Dallas, PA

All providers in Dallas, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.