Active NPI
Jakob Robert Demedal, DPT
- Physical Therapist
- Wexford, PA
National Provider Identifier
1710430285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT025408
- Practice address
- 100 Bradford Rd Ste 210
Wexford, PA 15090-8485 - Phone
- (724) 940-2323
- NPI assigned
- Aug 1, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT025408 | PA | Primary |
Addresses
Primary practice location
100 Bradford Rd Ste 210
Wexford, PA 15090-8485
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 541-1974
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Procare Physical Therapy Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Towanda, PA
- NPI 1003876319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625616000000",
"number": "1710430285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "HOOVER",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-541-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BRADFORD RD STE 210",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150908485",
"telephone_number": "724-940-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMEDAL",
"first_name": "JAKOB",
"middle_name": "ROBERT",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-01",
"last_updated": "2021-07-07",
"certification_date": "2021-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT025408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.