Individual provider Active NPI

Stevie Lynn Calabrese

  • Physical Therapist
  • Wilkes Barre, PA
National Provider Identifier
1710275755
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 021443 Issued in PA
Practice address
1086 Highway 315 Blvd
Wilkes Barre, PA 18702-7012
Phone
(570) 823-7761
Fax
(570) 829-7761
NPI assigned
Jul 12, 2011
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 PT 021443 PA Primary

Addresses

Primary practice location

1086 Highway 315 Blvd
Wilkes Barre, PA 18702-7012

Mailing address

1086 Highway 315 Blvd
Wilkes Barre, PA 18702-7012
Phone (570) 823-7761

Other practice location 1

106 Rotary Dr
West Hazleton, PA 18202-1182
Phone (570) 459-6333

Other practice location 2

693 Main St
New Milford, PA 18834-7200
Phone (570) 465-2027

Other practice location 3

87 Oxford St
Hanover Township, PA 18706-3350
Phone (570) 825-3909

Other names 1

  • Stevie Dorbad Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624003042 PA Practitioner - Physical Therapist in Private Practice 2567905110 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derek Enterprises LLCGroup PAC ID 1355791252, 4 clinicians

Practice addresses (Care Compare)

106 Rotary Dr
West Hazleton, PA 18202-1182
Phone (570) 459-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 021443PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Steffie Enterprises, Inc Physical Therapist CurrentSince May 28, 2024 Accepting new patients
Derek Enterprises LLC Physical Therapist CurrentSince May 28, 2024 Accepting new patients
Dylan RC Enterprises Inc Physical Therapist CurrentSince May 28, 2024 Accepting new patients
Alycam Inc Physical Therapist CurrentSince May 28, 2024 Accepting new patients

Locations

87 Oxford St
Hanover Township, PA 18706
Phone (570) 387-2202

100 N Mountain Blvd
Mountain Top, PA 18707
Phone (570) 474-1171

693 Main St
New Milford, PA 18834
Phone (570) 465-2027

106 Rotary Dr
West Hazleton, PA 18202
Phone (570) 455-2286

1086 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (570) 823-7761

Organizations & group practices 4

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": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1710275755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027012",
            "telephone_number": "570-823-7761",
            "fax_number": "570-822-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 HIGHWAY 315 BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027012",
            "telephone_number": "570-823-7761",
            "fax_number": "570-829-7761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Rotary Dr",
            "address_purpose": "LOCATION",
            "city": "West Hazleton",
            "state": "PA",
            "postal_code": "182021182",
            "country_code": "US",
            "telephone_number": "570-459-6333",
            "fax_number": "570-459-5255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "693 Main St",
            "address_purpose": "LOCATION",
            "city": "New Milford",
            "state": "PA",
            "postal_code": "188347200",
            "country_code": "US",
            "telephone_number": "570-465-2027",
            "fax_number": "570-465-2028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "87 Oxford St",
            "address_purpose": "LOCATION",
            "city": "Hanover Township",
            "state": "PA",
            "postal_code": "187063350",
            "country_code": "US",
            "telephone_number": "570-825-3909",
            "fax_number": "570-825-8939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRESE",
        "first_name": "STEVIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT 021443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVIE",
            "last_name": "DORBAD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.