Individual provider Active NPI

Vincent J Basile, PT

  • Physical Therapist
  • Bloomsburg, PA
National Provider Identifier
1861416174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT000477L Issued in PA
Practice address
410 Glen Avenue
Medical Professional Building, Suiite 101
Bloomsburg, PA 17815
Phone
(570) 387-2135
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT000477L PA Primary

Addresses

Primary practice location

410 Glen Avenue
Medical Professional Building, Suiite 101
Bloomsburg, PA 17815

Mailing address

17 Maplewood Rd
Berwick, PA 18603-5626

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT000477LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Encompass Health Limited Liability Company Past Accepting new patients
Susquehanna Physical Therapy Associates, Inc. Past Accepting new patients

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861416174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MAPLEWOOD RD",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186035626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 GLEN AVENUE",
            "address_2": "MEDICAL PROFESSIONAL BUILDING, SUIITE 101",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "17815",
            "telephone_number": "570-387-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILE",
        "first_name": "VINCENT",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT000477L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.