Premier Orthopaedic and Sports Medicine
NPI 1104169143ActiveOrganization· Physical Therapist· Bryn Mawr, PA
Physical Therapist in Bryn Mawr, Pennsylvania, registered in NPPES in March 2013. The authorized official on file is Darlene Buddy, Credentialing Coordinator.
Overview
| NPI | 1104169143 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 28, 2013 |
| Last updated in NPPES | Jan 31, 2022 |
| Certified by provider | Jan 27, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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