Active NPI
Susan E Weidman, PT
- Physical Therapist
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT009821L
- Practice address
- 9475 Roosevelt Blvd
Philadelphia, PA 19114-2212 - Phone
- (215) 464-6200
- NPI assigned
- Oct 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT009821L | PA | Primary |
Addresses
Primary practice location
9475 Roosevelt Blvd
Philadelphia, PA 19114-2212
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016908650002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Hahnemann University College of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9475 E Roosevelt Blvd
Philadelphia, PA 19114-2212
Phone (215) 464-6200
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.05 of 100
- Quality
- 89.12
- Improvement activities
- 40
- Cost
- 73.46
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holdings, LLC | Physical Therapist | Current | Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current | Accepting new patients |
| Medical Center of Bustleton PC | Past | Accepting new patients | |
| Ati Holdings, LLC | Past | Accepting new patients | |
| Pinnacle Physicians Group LLC | Past | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
101 W City Ave
Ste B
Bala Cynwyd, PA 19004
Phone (484) 270-9170
2641 Street Rd
Bensalem, PA 19020
Phone (267) 525-0135
28 E Ridge Pike
#A3
Conshohocken, PA 19428
Phone (484) 533-2692
307 E Street Rd
Feasterville Trevose, PA 19053
Phone (267) 989-2278
634 Old York Rd
Jenkintown, PA 19046
Phone (215) 881-9181
2022 E Old Lincoln Hwy
Ste 6
Langhorne, PA 19047
Phone (215) 891-5150
169 Levittown Pkwy
Ste D
Levittown, PA 19055
Phone (215) 377-9932
2121 Cottman Ave
#14
Philadelphia, PA 19149
Phone (267) 668-1891
180 W Girard Ave
Ste 1
Philadelphia, PA 19123
Phone (267) 592-4033
9475 Roosevelt Blvd
#B4
Philadelphia, PA 19114
Phone (215) 464-6200
626 Market St
Philadelphia, PA 19106
9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200
7164 Ridge Ave
Ste 17A
Philadelphia, PA 19128
Phone (267) 748-2430
1100 S Christopher Columbus Blvd
Ste 25
Philadelphia, PA 19147
Phone (267) 592-4508
118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Rising Sun, MD
- NPI 1396781050
PA, Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- King of Prussia, PA
- NPI 1750194460
Physical Therapist
-
- Internal Medicine Physician
- Philadelphia, PA
- NPI 1861576753
-
- Family Medicine Physician
- Trevose, PA
- NPI 1184984809
-
- Durable Medical Equipment & Medical Supplies
- Forest Hill, MD
- NPI 1013109099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1891784740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9475 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191142212",
"telephone_number": "215-464-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEIDMAN",
"first_name": "SUSAN",
"middle_name": "E",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-13",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT009821L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016908650002",
"state": "PA"
}
],
"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 Feb 21, 2013; 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.