Individual provider Active NPI

Lacie Renee Cumo, PT

  • Physical Therapist
  • Bedford, PA
National Provider Identifier
1881949121
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020395 Issued in PA
Practice address
9613 Lincoln Hwy
Suite 107
Bedford, PA 15522-3748
Phone
(814) 623-1042
Fax
(814) 623-1044
NPI assigned
Jul 23, 2012
Last updated
Mar 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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 PT020395 PA Primary

Addresses

Primary practice location

9613 Lincoln Hwy
Suite 107
Bedford, PA 15522-3748

Mailing address

5300 Derry St
2ND Floor
Harrisburg, PA 17111-3576
Phone (717) 839-2110

Other names 1

  • Lacie Renee Mororro Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170404000529 PA Practitioner - Physical Therapist in Private Practice 0547546665 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Benchmark Therapy, Inc. Past Accepting new patients
Benchmark Therapy, Inc Physical Therapist Past Accepting new patients
Benchmark Therapy, Inc Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

9613 Lincoln Hwy
Ste 107
Bedford, PA 15522
Phone (814) 623-1042

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1881949121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 DERRY ST",
            "address_2": "2ND FLOOR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113576",
            "telephone_number": "717-839-2110",
            "fax_number": "717-565-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9613 LINCOLN HWY",
            "address_2": "SUITE 107",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155223748",
            "telephone_number": "814-623-1042",
            "fax_number": "814-623-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMO",
        "first_name": "LACIE",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACIE",
            "last_name": "MORORRO",
            "middle_name": "RENEE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.