Individual provider Active NPI

Samuel Kelly, DPT

  • Orthopedic Physical Therapist
  • Levittown, PA
National Provider Identifier
1831690940
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
1411 Woodbourne Rd Ste B
Levittown, PA 19057-1540
Phone
(267) 630-5740
Fax
(267) 630-5741
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

1411 Woodbourne Rd Ste B
Levittown, PA 19057-1540

Mailing address

120 W Germantown Pike Ste 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

Enrollment IDStateProvider typePAC IDDetails
I20180328001510 PA Practitioner - Physical Therapist in Private Practice 8628330800 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy LLCGroup PAC ID 1951530849, 430 clinicians

Practice addresses (Care Compare)

8015 Frankford Ave
Philadelphia, PA 19136-2736
Phone (215) 338-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Services, Inc. Orthopedic CurrentSince Feb 26, 2018 Accepting new patients
Progress Physical Therapy LLC Orthopedic CurrentSince Feb 10, 2025 Accepting new patients

Locations

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

1411 Woodbourne Rd
Ste B
Levittown, PA 19057
Phone (267) 630-5740

17 Blacksmith Rd
Ste 116
Newtown, PA 18940
Phone (215) 383-3133

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1831690940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W GERMANTOWN PIKE STE 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": "1411 WOODBOURNE RD STE B",
            "city": "LEVITTOWN",
            "state": "PA",
            "postal_code": "190571540",
            "telephone_number": "267-630-5740",
            "fax_number": "267-630-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMUEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.