Individual provider Active NPI

Susan Marie Andrews, MSPT

  • Physical Therapist
  • Montgomery, PA
National Provider Identifier
1679552087
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
DAPT000609 Issued in PA
Practice address
43 S Main St
Montgomery, PA 17752-1120
Phone
(570) 547-0480
Fax
(570) 547-0498
NPI assigned
Jan 13, 2006
Last updated
Sep 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

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 DAPT000609 PA Primary

Addresses

Primary practice location

43 S Main St
Montgomery, PA 17752-1120

Mailing address

43 S Main St
Montgomery, PA 17752-1120
Phone (570) 547-0480

Other identifiers 1

IdentifierTypeStateIssuer
1011315740001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000039 PA Practitioner - Physical Therapist in Private Practice 9133182785 Reassigns benefits to 1 organization
Practice locations: Montgomery, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DAPT000609PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Rehabilitation, LLC Physical Therapist CurrentSince Jul 10, 2017 Accepting new patients
Susan M Andrews Physical Therapist PastSince Jan 1, 1990 Accepting new patients

Locations

43 S Main St
Montgomery, PA 17752
Phone (570) 547-0480

Organizations & group practices 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1679552087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 S MAIN ST",
            "city": "MONTGOMERY",
            "state": "PA",
            "postal_code": "177521120",
            "telephone_number": "570-547-0480",
            "fax_number": "570-547-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 S MAIN ST",
            "city": "MONTGOMERY",
            "state": "PA",
            "postal_code": "177521120",
            "telephone_number": "570-547-0480",
            "fax_number": "570-547-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "DAPT000609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011315740001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.