Organization Active NPI

Sdi Therapy, LLC

  • Physical Therapy Clinic/Center
  • Hatboro, PA
National Provider Identifier
1871132126
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SDI THERAPY, LLC
Practice address
319 W County Line Rd Ste 9
Hatboro, PA 19040-1605
Phone
(215) 470-1652
Fax
(610) 471-0488
NPI assigned
Jan 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Ilan Immerman, DPTNPI 1649528506
Title
President
Phone
(561) 809-1638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

319 W County Line Rd Ste 9
Hatboro, PA 19040-1605

Mailing address

1610 Iron Horse Rd
Huntingdon Valley, PA 19006-7752
Phone (561) 809-1638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220520002280 PA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709290760 Receives reassigned benefits from 5 practitioners
Practice locations: Hatboro, PA

National Provider Directory

National Provider Directory

Locations

319 W County Line Rd
Ste 9
Hatboro, PA 19040
Phone (215) 470-1652

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1871132126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 IRON HORSE RD",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190067752",
            "telephone_number": "561-809-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W COUNTY LINE RD STE 9",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190401605",
            "telephone_number": "215-470-1652",
            "fax_number": "610-471-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDI THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-04",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "IMMERMAN",
        "authorized_official_first_name": "ILAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-809-1638",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.