Gerald John Vitale Jr., PTA, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

64 Ridgway Dr Ste 1
Dallas, PA 18612-9263

Phone

(570) 675-1866

NPI assigned

Feb 2, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cip Rehabilitation IncGroup PAC ID 4789932104, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cip Rehabilitation Inc

  • Occupational Therapist
  • Dallas, PA
  • NPI 1669963039

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1841943578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1083",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-332-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 RIDGWAY DR STE 1",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186129263",
            "telephone_number": "570-675-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "GERALD",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "PTA, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce Vandeutsch, PA-C
• Cailyn R Vanhouten, OTR/L
• Vision Innovation Centers of Pennsylvania LLC
• Vision Innovation Centers of Pennsylvania, LLC
• Lisa Ann Visneski, MS, CCC-SLP
• Luisanna Soto Wadsworth, PA
• Walgreen Co (Walgreens #09228)
• Rachael Ann Waligun, MSN, CRNP, PMHNP-BC
• Hannah Warner, OTR/L
• Watkins & Medura

• Physical Therapist in Dallas, PA
• Providers in Dallas, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.