Andrew John Dornisch, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009862L Issued in PA

Practice address

104 Metoxet St
Ridgway, PA 15853-1932

Phone

(814) 788-5534

Fax

(814) 788-5549

NPI assigned

Aug 28, 2015

Last updated

Aug 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elk Regional Professional Group, Inc.Group PAC ID 4486553278, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elk Regional Professional Group Inc

  dba Penn Highlands Professional Group

  • Rehabilitation Clinic/Center
  • Kane, PA
  • NPI 1982073854

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Elk Regional Professional Group, Inc.

  • Nurse Practitioner
  • Ridgway, PA
  • NPI 1982668885
  NPD

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1942677679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 METOXET ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531932",
            "telephone_number": "814-788-5534",
            "fax_number": "814-788-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 METOXET ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531932",
            "telephone_number": "814-788-5534",
            "fax_number": "814-788-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNISCH",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT009862L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Detsch
• Dickinson Center, Inc
• Dickinson Center, Inc
• Dickinson Center, Inc/Autism OT
• Dickinson Mental Health Center, Inc
• Dubois Reg Med Ctr - Penn Highlands Dubois Q-Care/Family Med Ridgeway (Penn Highlands DuBois)
• Dubois Regional Medical Center (Penn Highlands Internal Med Elk/Family Med Elk)
• Dubois Regional Medical Center (Penn Highlands DuBois)
• Dubois Regional Medical Center (Penn Highlands DuBois)
• Dubois Regional Medical Center

• Physical Therapist in Ridgway, PA
• Providers in Ridgway, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.