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MR. METODIO AMAHIT PAMPLONA JR. P.T.
NPI 1548494297
Physical Therapist in Laurel, DE

Active since May 11, 2009Accepts Medicare Assignment
85/100
CMS Quality Rating
404 E FRONT ST, LAUREL, DE 19956(302) 280-6920(302) 280-6921 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Metodio Amahit Pamplona Jr. P.t. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. METODIO AMAHIT PAMPLONA JR. P.T. (NPI 1548494297) is an individual physical therapist in Laurel, Delaware, licensed in Delaware (J1-0002113) and active in the NPI registry since May 2009. He is a graduate of Other (1997).

NPPES Registry Identity

NPI1548494297
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameMR. METODIO AMAHIT PAMPLONA JR.Credential: P.T.
Location Address404 E FRONT STLaurel, DE 19956-1741
Mailing Address404 E Front StLaurel, DE 19956-1741 · (302) 280-6920 · Fax (302) 280-6921
Phone(302) 280-6920
Fax(302) 280-6921
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateMay 11, 2009
Last NPPES UpdateDecember 30, 2020
NPPES CertifiedDecember 30, 2020
✔ NPI 1548494297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in DE · J1-0002113
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
404 E FRONT ST, Laurel, DE 19956
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Metodio Amahit Pamplona Jr. P.t. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779482922
PECOS Enrollment IDI20090908000607

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
3,294 services232 patients
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112
This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
1,965 services183 patients
Therapy procedure using functional activities 97530
A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
1,689 services250 patients
Therapy procedure using manual technique, each 15 minutes 97140
This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
811 services112 patients
Therapy procedure for walking training, each 15 minutes 97116
Walking training therapy is a process to improve your ability to walk. It's a 15-minute session where you'll practice walking with the help of devices or exercises. It aims to enhance balance, strength, coordination, and endurance.
349 services38 patients
Evaluation for physical therapy, typically 20 minutes 97161
An evaluation for physical therapy is a short, 20-minute assessment where your physical condition, mobility, and pain levels are examined. This helps in designing a personalized therapy plan to enhance your physical function and well-being.
248 services224 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19956 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality70.01
Improvement Activities40

Reported Quality Measures

Documentation of Current Medications in the Medical Record
100%415 patients5/55-star benchmark: 100%
Elder Maltreatment Screen and Follow-Up Plan
100%258 patients
Functional Outcome Assessment
100%417 patients5/55-star benchmark: 100%
Functional Status Change for Patients with Hip Impairments
30%33 patients2/55-star benchmark: 100%
Functional Status Change for Patients with Knee Impairments
22%50 patients1/55-star benchmark: 100%
Functional Status Change for Patients with Low Back Impairments
22%60 patients1/55-star benchmark: 100%
Functional Status Change for Patients with Shoulder Impairments
11%35 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
98%366 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKESIDE PHYSICAL THERAPY, LLC
Rehabilitation Practitioner
404 E FRONT ST
LAUREL, DE 19956
Sussex County (302) 280-6920
LORNA KREDELL
Physical Therapist
404 E FRONT ST
LAUREL, DE 19956
Sussex County (302) 280-6920
MYUNGSUNG KO DPT
Physical Therapist
404 E FRONT ST
LAUREL, DE 19956
Sussex County (302) 280-6920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Metodio Pamplona's NPI number?

The NPI number for Metodio Pamplona is 1548494297. It was assigned to this individual provider in the NPPES registry on May 11, 2009.

Where is Metodio Pamplona located?

Metodio Pamplona practices at 404 E Front St, Laurel, DE 19956. The listed phone number is (302) 280-6920.

What is Metodio Pamplona's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Metodio Pamplona enrolled in Medicare?

Yes. Metodio Pamplona is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Metodio Pamplona accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Metodio Pamplona as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Metodio Pamplona was last updated on December 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.