Individual provider Active NPI

Sandra Ustaris

  • Physical Therapist
  • Phila, PA
National Provider Identifier
1942313549
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 017952 Issued in PA
Practice address
2129 W Oregon Ave
Phila, PA 19145-4131
Phone
(215) 336-6630
Fax
(215) 336-3928
NPI assigned
Aug 16, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 PT 017952 PA Primary

Addresses

Primary practice location

2129 W Oregon Ave
Phila, PA 19145-4131

Mailing address

2129 W Oregon Ave
Phila, PA 19145-4131
Phone (215) 336-6630

Other names 1

  • Sandra Ustaris Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419000165 PA Practitioner - Physical Therapist in Private Practice 5698962876 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 017952PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Luna Care Physical Therapy LLC Physical Therapist CurrentSince Mar 18, 2022 Accepting new patients

Locations

300 Welsh Rd
Bldg 1
Horsham, PA 19044

Organizations & group practices 1

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1942313549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 W OREGON AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191454131",
            "telephone_number": "215-336-6630",
            "fax_number": "215-336-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 W OREGON AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191454131",
            "telephone_number": "215-336-6630",
            "fax_number": "215-336-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USTARIS",
        "first_name": "SANDRA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT 017952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "USTARIS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.