JEROME JAMES DERISO (MPT) – Physical Therapist, NPI 1689728867

JEROME JAMES DERISO (MPT) is a healthcare provider. based in Ligonier, Pennsylvania. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MPT. They hold a License No. PT008042L (PA). The NPI Number for JEROME JAMES DERISO (MPT) is 1689728867

Main info

Male
Sole Proprietor
33 Years Of Experience
Accepts Medicare Assignment
Name
JEROME JAMES DERISO (MPT)
NPI
1689728867
Phone
Not provided
Address
1865 ROUTE 30
Enumeration Date
23 January 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7242389185
Graduation Year
1993 (33 years ago)
PAC ID
8628079407
Group Practice PAC ID
9537237904
Professional Enrollment ID
I20070122000324
Address ID
PA156589239LI1865XWXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,258 PHYSICAL THERAPIST IN PRIVATE PRACTICE in PA

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Provider Addresses for JEROME JAMES DERISO (MPT)

  • State Route 1021, Ligonier Township, Westmoreland County, Pennsylvania, 15658, United States

    LIGONIER, PA 156588515

    Phone:

    Mailing address matches the actual address.

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: 2007-01-22

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
I20070122000324IPhysical Therapist In Private PracticePATBD

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 minutes4,026103$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care1,27692$0
97140Therapy procedure using manual technique, each 15 minutes1,25691$0
97035Application of ultrasound, each 15 minutes68478$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes61056$0
View full utilization report →

Insurance plans in this area (ZIP 15658)

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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: 9537237904View full group profile
NameSpecialtyState
Physical Therapist In Private PracticePA

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Frequently asked questions

What identifier follows JEROME JAMES DERISO (MPT) across health systems?
The NPI 1689728867 uniquely identifies JEROME JAMES DERISO (MPT) in U.S. healthcare data.
Is JEROME JAMES DERISO (MPT)'s NPI status active today?
Active status means JEROME JAMES DERISO (MPT)'s NPI record is not deactivated in the public file.
How should patients interpret JEROME JAMES DERISO (MPT)'s specialty?
The extract shows Physical Therapist for JEROME JAMES DERISO (MPT). Clinical services aligned with this taxonomy classification.
What city is tied to JEROME JAMES DERISO (MPT)?
The directory associates JEROME JAMES DERISO (MPT) with Ligonier, Pennsylvania. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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