Organization Active NPI

Peak Health Physical Therapy

  • Physical Therapist
  • Rochelle Park, NJ
National Provider Identifier
1023547205
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01117600 Issued in NJ
Legal business name
PEAK HEALTH PHYSICAL THERAPY
Practice address
50 Essex St
Rochelle Park, NJ 07662-4341
Phone
(201) 647-3669
Fax
(201) 212-6393
NPI assigned
Jun 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Mr. Stephen Tawadros, P.T.NPI 1083733208
Title
Owner/Physical Therapist
Phone
(201) 647-3669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 40QA01117600 NJ Primary

Addresses

Primary practice location

50 Essex St
Rochelle Park, NJ 07662-4341

Mailing address

623 Lafayette Ave Ste 101
Hawthorne, NJ 07506-2439
Phone (201) 647-3669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230306001957 NJ Part B Supplier - Clinic/Group Practice 9335512714 Receives reassigned benefits from 1 practitioner
Practice locations: Hawthorne, NJ

National Provider Directory

National Provider Directory

Locations

623 Lafayette Ave
Ste 101
Hawthorne, NJ 07506
Phone (201) 647-3669

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1023547205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 LAFAYETTE AVE STE 101",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062439",
            "telephone_number": "201-647-3669",
            "fax_number": "201-212-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ESSEX ST",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624341",
            "telephone_number": "201-647-3669",
            "fax_number": "201-212-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK HEALTH PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "TAWADROS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "201-647-3669",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01117600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.