Advanced Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012778L Issued in PA

Legal business name

ADVANCED PHYSICAL THERAPY

Doing business as

Michael Beaudoin

Practice address

2127 Rhawn St
Philadelphia, PA 19152-3216

Phone

(215) 742-8099

Fax

(215) 742-1871

NPI assigned

Aug 30, 2006

Last updated

Mar 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Beaudoin, DPTNPI 1861472078

Title

Physical Therapist/Owner

Phone

(215) 742-8099

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• MICHAEL BEAUDOIN Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 4

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.

• Michael Beaudoin, DPT

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1861472078
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren M Abernethy, DPT

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1043620974
  Medicare reassignment Care Compare group NPD
• David Malone

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1063086403
  Medicare reassignment Care Compare group NPD
• Julia Crusemire, PT, DPT

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1689050619
  Medicare reassignment NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1689784217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523216",
            "telephone_number": "215-742-8099",
            "fax_number": "215-742-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 RHAWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523216",
            "telephone_number": "215-742-8099",
            "fax_number": "215-742-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "BEAUDOIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "215-742-8099",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT012778L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "01726303",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30023534",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2395652000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ PLUS",
            "identifier": "246902",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3985602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHAEL BEAUDOIN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.