Organization Active NPI

Physical Therapy and Wellness Institute LLC

  • Physical Therapist
  • Lansdale, PA
National Provider Identifier
1740208339
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
DAPT000285 Issued in PA
Legal business name
PHYSICAL THERAPY AND WELLNESS INSTITUTE LLC
Practice address
730 S Broad St
Lansdale, PA 19446-5211
Phone
(215) 855-9871
Fax
(215) 855-8748
NPI assigned
Jul 18, 2006
Last updated
Aug 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Michael Rucker
Title
Ceo
Phone
(914) 777-8700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X DAPT000285 PA Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

730 S Broad St
Lansdale, PA 19446-5211

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050421001158 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1557309358 Receives reassigned benefits from 179 practitioners
Practice locations: Perkasie, PA; Warminster, PA; Souderton, PA; Royersford, PA; Quakertown, PA; North Wales, PA; Norristown, PA; Newtown Square, PA…

National Provider Directory

National Provider Directory

Locations

110 Ardmore Ave
Ste A
Ardmore, PA 19003
Phone (484) 498-8299

558 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

2285 Cross Rd
Ste 3
Glenside, PA 19038
Phone (215) 887-2001

1540 Cowpath Rd
Hatfield, PA 19440
Phone (215) 412-9264

1540 Cowpath Rd
Ste 100
Hatfield, PA 19440
Phone (215) 855-3359

575 Horsham Rd
Unit B16
Horsham, PA 19044
Phone (215) 364-5893

730 S Broad St
Lansdale, PA 19446
Phone (215) 855-9871

1083 W Baltimore Pike
Ste E
Media, PA 19063
Phone (484) 214-4080

3537 West Chester Pike
Newtown Square, PA 19073
Phone (610) 601-9177

1131 N 5th St
Perkasie, PA 18944
Phone (215) 396-5655

1837 E Ridge Pike
Ste 30
Royersford, PA 19468
Phone (610) 409-5655

157 Railroad Dr
Warminster, PA 18974
Phone (215) 987-3677

1167 Wilmington Pike
West Chester, PA 19382
Phone (484) 567-4343

Practitioners & affiliated clinicians

Practitioners 250

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.

View all 250

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1740208339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465211",
            "telephone_number": "215-855-9871",
            "fax_number": "215-855-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND WELLNESS INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "914-777-8700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "DAPT000285",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.