Justin D. Ditheodore, PT
NPI 1073836656ActiveIndividual· Physical Therapist· Vineland, NJ
Physical Therapist (PT) with Premier Orthopaedic and Sports Medicine Assoc of Southern Nj LLC, practicing in Vineland, New Jersey. Medicare paid $67,348 for services to 90 patients in 2024.
Overview
| NPI | 1073836656 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | No |
| NPI issued | Mar 10, 2010 |
| Last updated in NPPES | Apr 29, 2020 |
| Certified by provider | Apr 29, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 40QA01339000 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NJ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 90 |
|---|---|
| Services billed | 3,066 across 8 procedure codes |
| Paid by Medicare | $67,348 |
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Premier Orthopaedic and Sports Medicine Assoc of Southern Nj LLCVineland, NJ · 37 clinicians
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All 79 physical therapists in Vineland · All physical therapists in New Jersey