Individual provider Active NPI

Joanna Suchcicka, DPT

  • Physical Therapist
  • East Brunswick, NJ
National Provider Identifier
1013104397
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01207900 Issued in NJ
Practice address
758 Highway 18
Suite 106
East Brunswick, NJ 08816-4910
Phone
(732) 290-0090
Fax
(732) 254-2292
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01207900 NJ Primary

Addresses

Primary practice location

758 Highway 18
Suite 106
East Brunswick, NJ 08816-4910

Mailing address

PO Box 4414
Brick, NJ 08723-1614
Phone (732) 785-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024731NYMDClinical Psychologist
40QA01207900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy of New York, P.C. Physical Therapist Past Accepting new patients
Endurance Rehabilitation and Wellness Center, PC Physical Therapist PastSince Apr 10, 2017 Accepting new patients
Lifespan Therapy & Sports Rehab LLC Physical Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1013104397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4414",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087231614",
            "telephone_number": "732-785-0040",
            "fax_number": "732-785-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 HIGHWAY 18",
            "address_2": "SUITE 106",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164910",
            "telephone_number": "732-290-0090",
            "fax_number": "732-254-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCHCICKA",
        "first_name": "JOANNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01207900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.