Jerome James Deriso, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008042L Issued in PA

Practice address

1865 Route 30
Ligonier, PA 15658-8515

Phone

(724) 238-9185

Fax

(724) 238-9186

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diamond Physical TherapyGroup PAC ID 9537237904, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Diamond Physical Therapy

  • Physical Therapy Clinic/Center
  • Ligonier, PA
  • NPI 1891880001

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689728867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 ROUTE 30",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156588515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 ROUTE 30",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156588515",
            "telephone_number": "724-238-9185",
            "fax_number": "724-238-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERISO",
        "first_name": "JEROME",
        "middle_name": "JAMES",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT008042L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy L Davis, R.PH.
• Vincent Decosmo, MD
• Joseph D Deluca
• Adam Dematteo
• Diana F Denning, MD
• Diamond Physical Therapy
• DLP Conemaugh Physician Practices LLC (Conemaugh Physician Group Ligonier)
• Dominion Therapy Services, LLC
• Sally C. Donnelly, PH.D.
• Dpa Medical Services Inc

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

• 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.
• 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.