Individual provider Active NPI

Ammar Mustafa

  • Physical Therapist
  • Ridgewood, NJ
National Provider Identifier
1023629854
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01943100 Issued in NJ
Practice address
85 S Maple Ave
Ridgewood, NJ 07450-4561
Phone
(551) 857-5396
NPI assigned
Aug 14, 2020
Last updated
Aug 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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 40QA01943100 NJ Primary

Addresses

Primary practice location

85 S Maple Ave
Ridgewood, NJ 07450-4561

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922000298 NJ Practitioner - Physical Therapist in Private Practice 1456779578 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

385 Lakeview Ave
Clifton, NJ 07011-4074
Phone (862) 668-3629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01943100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Dec 6, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Nov 1, 2020 Accepting new patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Bounce Back Physical Therapy LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Nov 1, 2020 Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

385 Lakeview Ave
Clifton, NJ 07011
Phone (973) 772-1004

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (440) 263-9228

999 Route 73 N
Ste 401
Marlton, NJ 08053

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

85 S Maple Ave
Ridgewood, NJ 07450
Phone (201) 445-2830

85 S Maple Ave
Ste 1
Ridgewood, NJ 07450
Phone (201) 857-5396

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

576 Broadhollow Rd
Melville, NY 11747

Interoperability endpoints

  • Direct secure messaging: ammar.mustafa.1@27245.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/27245/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1023629854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 S MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504561",
            "telephone_number": "551-857-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "AMMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01943100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.