Active NPI
Randy Neri
- Physical Therapist
- East Stroudsburg, PA
National Provider Identifier
1790762409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT006553L
- Practice address
- 600 Office Plaza
Suite C
East Stroudsburg, PA 18301 - Phone
- (570) 421-7020
- NPI assigned
- Dec 23, 2005
- 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 | PT006553L | PA | Primary |
Addresses
Primary practice location
600 Office Plaza
Suite C
East Stroudsburg, PA 18301
Mailing address
600 Plaza CT Ste a
East Stroudsburg, PA 18301-8263
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT006553L | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pocono Advanced Medical Clinic PC | 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.
-
- Specialist
- East Stroudsburg, PA
- NPI 1053668798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1790762409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 PLAZA CT STE A",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183018263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 OFFICE PLAZA",
"address_2": "SUITE C",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "18301",
"telephone_number": "570-421-7020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NERI",
"first_name": "RANDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-23",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT006553L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.