Active NPI
Mark Dinicola
- Orthopedic Physical Therapist
- Philadelphia, PA
National Provider Identifier
1700466844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT029243
- Practice address
- 2328 S 16TH St
Philadelphia, PA 19145-4310 - Phone
- (267) 679-3017
- NPI assigned
- Apr 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT029243 | PA | Primary |
Addresses
Primary practice location
2328 S 16TH St
Philadelphia, PA 19145-4310
Mailing address
2328 S 16TH St
Philadelphia, PA 19145-4310
Phone (267) 679-3017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT029243 | PA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Progress Physical Therapy LLC | Orthopedic | Current | Accepting new patients |
| Neurosurgical Care, LLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EACEAA
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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Collegeville, PA
- NPI 1265629323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706659200000",
"number": "1700466844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2328 S 16TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191454310",
"telephone_number": "267-679-3017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2328 S 16TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191454310",
"telephone_number": "267-679-3017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINICOLA",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-13",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "PA",
"license": "PT029243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.