Individual provider Active NPI

Vincent Opdyke, PT, DPT

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1982471272
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT031297 Issued in PA
Practice address
10 Shurs LN Ste 101
Philadelphia, PA 19127-2123
Phone
(267) 437-2486
Fax
(267) 437-2491
NPI assigned
Dec 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 PT031297 PA Primary

Addresses

Primary practice location

10 Shurs LN Ste 101
Philadelphia, PA 19127-2123

Mailing address

PO Box 411503
Boston, MA 02241-1503
Phone (914) 294-4050

Other practice location 1

2000 Hamilton St Ste 211
Philadelphia, PA 19130-3814
Phone (215) 383-0220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240202000677 PA Practitioner - Physical Therapist in Private Practice 9436502788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progress Physical Therapy LLCGroup PAC ID 1951530849, 430 clinicians

Practice addresses (Care Compare)

10 Shurs LN
Suite 101
Philadelphia, PA 19127-2123
Phone (267) 437-2486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT031297PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Dec 5, 2023 Accepting new patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Dec 5, 2023 Accepting new patients
Wallace & Nilan Physical Therapy and Fitness, LLC Physical Therapist PastSince May 21, 2011 Accepting new patients

Locations

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

1600 Bethlehem Pike
Flourtown, PA 19031
Phone (215) 233-9677

2000 Hamilton St
Ste 211
Philadelphia, PA 19130
Phone (215) 383-0220

10 Shurs Ln
Ste 101
Philadelphia, PA 19127
Phone (267) 437-2486

Organizations & group practices 3

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1982471272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022411503",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SHURS LN STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "267-437-2486",
            "fax_number": "267-437-2491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Hamilton St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191303814",
            "country_code": "US",
            "telephone_number": "215-383-0220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPDYKE",
        "first_name": "VINCENT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT031297",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 6, 2023; 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.