Individual provider Active NPI

Anthony Diorisio, PT, DPT

  • Physical Therapist
  • Logan Township, NJ
National Provider Identifier
1760560163
Registry record updated Jun 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA012253 Issued in NJ
Practice address
520 Beckett Rd Ste 200
Logan Township, NJ 08085-1732
Phone
(856) 467-3421
Fax
(856) 467-5731
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2009

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 40QA012253 NJ Primary

Addresses

Primary practice location

520 Beckett Rd Ste 200
Logan Township, NJ 08085-1732

Mailing address

520 Beckett Rd Ste 200
Logan Township, NJ 08085-1732
Phone (856) 467-3421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200824003331 NJ Practitioner - Physical Therapist in Private Practice 4688826324 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA012253NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT Inc CurrentSince May 18, 2023 Accepting new patients
Rehabclinics SPT Inc. Current Accepting new patients

Locations

2144 US Highway 130
Ste 12
Bordentown, NJ 08505
Phone (609) 324-9320

127 Bridgeton Pike
Unit D
Mullica Hill, NJ 08062
Phone (856) 478-0275

269 N Broadway
#B
Pennsville, NJ 08070
Phone (856) 678-5484

520 Beckett Rd
Ste 200
Swedesboro, NJ 08085
Phone (856) 467-3421

Organizations & group practices 2

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245974400000",
    "number": "1760560163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 BECKETT RD STE 200",
            "city": "LOGAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851732",
            "telephone_number": "856-467-3421",
            "fax_number": "856-467-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 BECKETT RD STE 200",
            "city": "LOGAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851732",
            "telephone_number": "856-467-3421",
            "fax_number": "856-467-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIORISIO",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2009-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA012253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; 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.