Stanley T Petrick, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011725L Issued in PA

Practice address

1201B N Church St Ste 308
Hazle Township, PA 18202-1454

Phone

(570) 455-7108

Fax

(570) 455-8835

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Phoenix Rehabilitation and Health Services, Inc.

  • Physical Therapist
  • Cranberry Township, PA
  • NPI 1720084155
  NPD (past)
• Phoenix Rehabilitation and Health Services, Inc.

  • Speech-Language Pathologist
  • Blairsville, PA
  • NPI 1972604783
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1881650281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WESTINGHOUSE DR STE 200",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160665238",
            "telephone_number": "724-343-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201B N CHURCH ST STE 308",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182021454",
            "telephone_number": "570-455-7108",
            "fax_number": "570-455-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "STANLEY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT011725L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1230503",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00199564",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "PE176517",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "820635",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "230232",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50038360",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dev Patel, PA-C
• Danielle Grace Elizabeth Pegg, PA-C
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01572)
• Samuel Perenich, PA
• Jonathan G Perry, MD
• Phoenix Rehabilitation and Health Services, Inc.
• Donna Podrazik, PSYD
• Thomas Pollock, DO
• Brittany Portonova, D.P.M.
• R & L Helpmates, Inc.

• Physical Therapist in Hazle Township, PA
• Providers in Hazle Township, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.