Individual provider Active NPI

Douglas Bryan Klein, P.T.

  • Physical Therapist
  • Media, PA
National Provider Identifier
1881663011
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015036 Issued in PA
Practice address
101 N Monroe St
2ND Floor
Media, PA 19063-3037
Phone
(484) 444-0135
Fax
(610) 565-3773
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 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 PT015036 PA Primary

Addresses

Primary practice location

101 N Monroe St
2ND Floor
Media, PA 19063-3037

Mailing address

412 Aldan Ave
Aldan, PA 19018-4204
Phone (610) 394-2645

Other identifiers 1

IdentifierTypeStateIssuer
KL1315092OtherPAHIGHMARK BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000684 NJ Practitioner - Physical Therapist in Private Practice 2567465636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Physical Therapy LLCGroup PAC ID 5496901720, 9 clinicians

Practice addresses (Care Compare)

2087 Shore Rd
Suite 24
Seaville, NJ 08230
Phone (609) 536-4995

215 N Main St
Suite 102
Cape May Court House, NJ 08210-2192
Phone (609) 536-4995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015036PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Physical Therapy LLC Physical Therapist CurrentSince Aug 1, 2012 Accepting new patients
Orthopedic Sports & Arthritis Surgery Past Accepting new patients
Leading Edge Physical Therapy & Sports Medicine, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1881663011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 ALDAN AVE",
            "city": "ALDAN",
            "state": "PA",
            "postal_code": "190184204",
            "telephone_number": "610-394-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MONROE ST",
            "address_2": "2ND FLOOR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633037",
            "telephone_number": "484-444-0135",
            "fax_number": "610-565-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "DOUGLAS",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "KL1315092",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.