Individual provider Active NPI

Joseph Daigneau

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1891393914
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT028816 Issued in PA
Practice address
379 Helene PL
Philadelphia, PA 19116-2740
Phone
(215) 960-1331
NPI assigned
Oct 12, 2020
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 PT028816 PA Primary

Addresses

Primary practice location

379 Helene PL
Philadelphia, PA 19116-2740

Mailing address

379 Helene PL
Philadelphia, PA 19116-2740
Phone (215) 960-1331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201124002617 PA Practitioner - Physical Therapist in Private Practice 4082025937 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT028816PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
La Fortaleza Physical Therapy Center Inc. Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
La Fortaleza Physical Therapy Center Inc Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Nov 2, 2020 Accepting new patients
La Fortaleza Physical Therapy Inc Physical Therapist PastSince Sep 1, 2021 Accepting new patients

Locations

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

400 Horsham Rd
Ste 105
Horsham, PA 19044
Phone (215) 442-9060

133 W Hunting Park Ave
Philadelphia, PA 19140
Phone (215) 324-0600

3251 Cedar St
Philadelphia, PA 19134
Phone (215) 427-2242

Organizations & group practices 4

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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1891393914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 HELENE PL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162740",
            "telephone_number": "215-960-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 HELENE PL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162740",
            "telephone_number": "215-960-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGNEAU",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.