Active NPI
Brian H Kopicko, DPT
- Orthopedic Physical Therapist
- Philadelphia, PA
National Provider Identifier
1740524073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT022482
- Practice address
- 925 Chestnut St
5TH Floor
Philadelphia, PA 19107-4216 - Phone
- (800) 419-8093
- Fax
- (215) 503-0540
- NPI assigned
- Nov 27, 2012
- 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 | PT022482 | PA | Primary |
Addresses
Primary practice location
925 Chestnut St
5TH Floor
Philadelphia, PA 19107-4216
Mailing address
120 W Germantown Pike
Suite 100
Plymouth Meeting, PA 19462-1420
Phone (610) 270-0370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT022482 | PA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services Inc | Orthopedic | Current | Accepting new patients |
Locations
7 Carnegie Plz
Cherry Hill, NJ 08003
470 N Lewis Rd
Limerick, PA 19468
Phone (610) 792-8800
1122 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (877) 407-4322
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1740524073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 W GERMANTOWN PIKE",
"address_2": "SUITE 100",
"city": "PLYMOUTH MEETING",
"state": "PA",
"postal_code": "194621420",
"telephone_number": "610-270-0370",
"fax_number": "610-270-0374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 CHESTNUT ST",
"address_2": "5TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074216",
"telephone_number": "800-419-8093",
"fax_number": "215-503-0540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPICKO",
"first_name": "BRIAN",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-27",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "PA",
"license": "PT022482",
"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 Nov 27, 2012; 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.