Individual provider Active NPI

Kenneth M Dotto, PT

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1700860178
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4538 Peach St
Erie, PA 16509-1364
Phone
(814) 864-6650
Fax
(814) 866-2595
NPI assigned
Nov 30, 2005
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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 Primary

Addresses

Primary practice location

4538 Peach St
Erie, PA 16509-1364

Mailing address

500 Market St
Suite 103
Beaver, PA 15009-2998
Phone (724) 728-7550

Other identifiers 1

IdentifierTypeStateIssuer
1007652850005MedicaidPA

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

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1700860178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARKET ST",
            "address_2": "SUITE 103",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150092998",
            "telephone_number": "724-728-7550",
            "fax_number": "724-728-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4538 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091364",
            "telephone_number": "814-864-6650",
            "fax_number": "814-866-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTTO",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007652850005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.