Individual provider Active NPI

John Charles Conglose

  • Physical Therapist
  • Monroeville, PA
National Provider Identifier
1952061533
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT030040 Issued in PA
Practice address
2550 Mosside Blvd Ste 415
Monroeville, PA 15146-3533
Phone
(412) 457-1109
NPI assigned
Dec 23, 2021
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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 PT030040 PA Primary

Addresses

Primary practice location

2550 Mosside Blvd Ste 415
Monroeville, PA 15146-3533

Mailing address

241 Catalina Dr
New Castle, PA 16105-4803
Phone (724) 714-5702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216002155 PA Practitioner - Physical Therapist in Private Practice 5193118016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

12311 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-3457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1952061533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CATALINA DR",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161054803",
            "telephone_number": "724-714-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MOSSIDE BLVD STE 415",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463533",
            "telephone_number": "412-457-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGLOSE",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.