Maven Northeast Bergen, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MAVEN NORTHEAST BERGEN, LLC

Practice address

201 Broad Ave # 2W
Palisades Park, NJ 07650-1508

Phone

(201) 977-4441

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Taylor LeeNPI 1568432011

Title

PT

Phone

(973) 800-0010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Taylor D Lee, DPT

  • Physical Therapist
  • Paramus, NJ
  • NPI 1568432011
  Medicare reassignment NPD Authorized official
• Ryan Alexander Carpenter, PT, DPT

  • Physical Therapist
  • Paramus, NJ
  • NPI 1932622768
  NPD (past)
• David Kwon, DPT

  • Physical Therapist
  • Montclair, NJ
  • NPI 1043526338
  NPD (past)
• Michael James Morton II, PT,DPT,ATC

  • Physical Therapist
  • Franklin Lakes, NJ
  • NPI 1598303067
  NPD (past)
• Amanda Ossig

  • Physical Therapist
  • Paramus, NJ
  • NPI 1679297303
  NPD (past)
• Sara M Velez, PT, DPT, MS, ATC

  • Physical Therapist
  • Hillsdale, NJ
  • NPI 1548493703
  NPD (past)
• Jerome W Yoo, PT

  • Physical Medicine & Rehabilitation Physician
  • Woodcliff Lake, NJ
  • NPI 1215917547
  NPD (past)

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1023782323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076530125",
            "telephone_number": "973-800-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BROAD AVE # 2W",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501508",
            "telephone_number": "201-977-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVEN NORTHEAST BERGEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "973-800-0010"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Sung Kim, O.D., Inc.
• Martin Sung Kim, O.D., Inc.
• Thyparampil M Mathew, LCSW
• Michele Marie Matos, BCBA
• Matthew Lee DDS NJ PC
• Mdusa
• Ashley Menchise, M.S. CCC SLP
• Metropolitan Eye Research & Surgery Institute P.a.
• Metrovision Inc
• MJ Optometry Group, PC

• Physical Therapy Clinic/Center in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.