Individual provider Active NPI

Susan E Weidman, PT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1891784740
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009821L Issued in PA
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

Updated by the provider on Feb 21, 2013

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 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

IdentifierTypeStateIssuer
0016908650002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000120 PA Practitioner - Physical Therapist in Private Practice 6800060583 Reassigns benefits to 1 organization

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
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

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 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 20, 2013 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 20, 2013 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.