Individual provider Active NPI

Teresa V Chang, PT

  • Physical Therapist
  • Hackensack, NJ
National Provider Identifier
1033310644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00211600 Issued in NJ
Practice address
214 State St
Hackensack, NJ 07601-5500
Phone
(201) 968-1200
Fax
(201) 968-1400
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 40QA00211600 NJ Primary

Addresses

Primary practice location

214 State St
Hackensack, NJ 07601-5500

Mailing address

49 Roosevelt Blvd
North Caldwell, NJ 07006-4126
Phone (201) 968-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106000074 NJ Practitioner - Physical Therapist in Private Practice 3971626532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Center, P.C.Group PAC ID 5294792602, 5 clinicians

Practice addresses (Care Compare)

277 Prospect Ave
Hackensack, NJ 07601-2512
Phone (201) 968-0303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00211600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Center, P.C. Physical Therapist CurrentSince Sep 8, 2023 Accepting new patients
Prospect Medical PC PastSince Sep 8, 2023 Accepting new patients
Professional Medical Rehabilitation PA Past Accepting new patients

Locations

277 Prospect Ave
Ste Lg
Hackensack, NJ 07601
Phone (201) 968-0303

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033310644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 ROOSEVELT BLVD",
            "city": "NORTH CALDWELL",
            "state": "NJ",
            "postal_code": "070064126",
            "telephone_number": "201-968-1200",
            "fax_number": "201-968-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 STATE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015500",
            "telephone_number": "201-968-1200",
            "fax_number": "201-968-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "TERESA",
        "middle_name": "V",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00211600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.