Marco Canlas Udpaga, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01980500 Issued in NJ

Practice address

3718 Church Rd
Mount Laurel, NJ 08054-1104

Phone

(856) 235-7100

NPI assigned

Nov 6, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Selah Rehab LLC

  • Physical Therapist
  • Pennsauken, NJ
  • NPI 1093608853
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1636156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1033874870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 HAMILTON CT",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081101243",
            "telephone_number": "215-459-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541104",
            "telephone_number": "856-235-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDPAGA",
        "first_name": "MARCO",
        "middle_name": "CANLAS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-06",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028922",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01980500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Dialysis LLC
• Tyler Dialysis LLC
• Morgan Tyson
• U.S. Healthworks Medical Group of New Jersey, PC
• Nneka Tionne Udoye, RBT
• Melanie Uhse
• Union Mill Supemarket LLC
• Unity Love Home Healthcare NJ
• Barrie Urbano, MSS, LSW
• Urofirst Care LLC

• Physical Therapist in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.