Individual provider Active NPI

Audrey Michiku Magbojos Nuesca

  • Physical Medicine & Rehabilitation Physician
  • South Orange, NJ
National Provider Identifier
1023881406
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
40QA02216900 Issued in NJ
Practice address
349 Valley St
South Orange, NJ 07079-2857
Phone
(973) 327-7868
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 40QA02216900 NJ Primary

Addresses

Primary practice location

349 Valley St
South Orange, NJ 07079-2857

Mailing address

349 Valley St
South Orange, NJ 07079-2857
Phone (973) 327-7868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231115001476 NJ Practitioner - Physical Therapist in Private Practice 5092162909 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exemplary Home Therapy Services LLCGroup PAC ID 0840658084, 20 clinicians
Holsman Physical Therapy and Wellness PCGroup PAC ID 2062666910, 24 clinicians

Practice addresses (Care Compare)

1616 Hamilton St
Belleville, NJ 07109-5346
Phone (856) 506-6281

408 Pompton Ave
Cedar Grove, NJ 07009-1813
Phone (973) 433-0732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Home Therapy Services LLC Single Specialty CurrentSince Feb 12, 2026 Accepting new patients
Holsman Physical and Occupational Therapy, PC Single Specialty CurrentSince Nov 6, 2023 Accepting new patients
Exemplary Home Therapy Services LLC CurrentSince Feb 12, 2026 Accepting new patients
Home Therapy, LLC Single Specialty CurrentSince Nov 6, 2023 Accepting new patients
Holsman Physical Therapy and Wellness PC Single Specialty CurrentSince Nov 6, 2023 Accepting new patients
Holsman Physical and Occupational Therapy PC CurrentSince Nov 6, 2023 Accepting new patients

Locations

408 Pompton Ave
Cedar Grove, NJ 07009
Phone (973) 433-0732

1700 State Rt 3
Clifton, NJ 07013
Phone (862) 249-4901

15-01 Broadway
Ste 12
Fair Lawn, NJ 07410
Phone (201) 355-5199

1600 Saint Georges Ave
Ste 107
Rahway, NJ 07065
Phone (732) 428-5566

Organizations & group practices 6

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": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1023881406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 VALLEY ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792857",
            "telephone_number": "973-327-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 VALLEY ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792857",
            "telephone_number": "973-327-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESCA",
        "first_name": "AUDREY MICHIKU",
        "middle_name": "MAGBOJOS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "40QA02216900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

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