JUSTIN D DITHEODORE (PT) – Physical Therapist, NPI 1073836656

JUSTIN D DITHEODORE (PT) is a healthcare provider. based in Vineland, New Jersey. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 40QA01339000 (NJ). The NPI Number for JUSTIN D DITHEODORE (PT) is 1073836656

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN D DITHEODORE (PT)
NPI
1073836656
Phone
(856) 690-1616
Address
352 S DELSEA DR STE C
Enumeration Date
10 March 2010
Last Update Date
29 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8566901616
Graduation Year
2009 (17 years ago)
PAC ID
3072640408
Group Practice PAC ID
1557388436
Professional Enrollment ID
I20100416000245
Address ID
NJ083604568VI298XXDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:16State licenses:1Digital endpointsOther names

4,923 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NJ

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Provider Addresses for JUSTIN D DITHEODORE (PT)

  • 352, South Delsea Drive, Vineland, Cumberland County, New Jersey, 08360, United States

    VINELAND, NJ 083605306

    Phone: (856) 690-1616

    Fax: (856) 690-1089

    Type: Mailing

  • 298, South Delsea Drive, Vineland, Cumberland County, New Jersey, 08360, United States

    VINELAND, NJ 083604568

    Phone: (856) 690-1616

    Fax: (856) 690-1089

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-04-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100416000245IPhysical Therapist In Private PracticeNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,76578$0
97140Therapy procedure using manual technique, each 15 minutes43947$0
97162Evaluation for physical therapy, typically 30 minutes7768$0
97164Re-evaluation for physical therapy, typically 20 minutes3424$0
View full utilization report →

Insurance plans in this area (ZIP 08360)

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Provider's Procedures

JUSTIN D DITHEODORE (PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYNJ97001Physical therapy evaluation8781
PHYSICAL THERAPYNJ97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1951160

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557388436View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNJ
Occupational Therapist In Private PracticeNJ
Orthopedic SurgeryNJ
Hand Surgery, Orthopedic SurgeryNJ
Physician AssistantNJ
Physical Therapist In Private PracticeNJ
P O D I A T R YPA
Orthopedic SurgeryNJ
Orthopedic SurgeryNJ
Orthopedic Surgery, Hand SurgeryNJ

Reviews

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Frequently asked questions

What is the registry number for JUSTIN D DITHEODORE (PT)?
The registry entry for JUSTIN D DITHEODORE (PT) shows NPI 1073836656.
Should I treat JUSTIN D DITHEODORE (PT) as an active provider?
Patients and plans typically see JUSTIN D DITHEODORE (PT) as active in the national extract.
How should patients interpret JUSTIN D DITHEODORE (PT)'s specialty?
The extract shows Physical Therapist for JUSTIN D DITHEODORE (PT). Clinical services aligned with this taxonomy classification.
Can patients visit JUSTIN D DITHEODORE (PT) in Vineland, New Jersey?
For routing, start with Vineland, New Jersey for JUSTIN D DITHEODORE (PT), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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