NPIMap

Organization Active NPI

Divine Spine Physical Therapy and Yoga LLC

  • Physical Therapy Clinic/Center
  • Monroe, NJ
National Provider Identifier
1043756778
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
40QA01469300 Issued in NJ
Legal business name
DIVINE SPINE PHYSICAL THERAPY AND YOGA LLC
Practice address
7 Centre Dr Ste 9
Monroe, NJ 08831-1565
Phone
(908) 444-6055
NPI assigned
Jan 19, 2017
Last updated
Jan 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Authorized official

Name
Rutvi Patel, PT, MS,OCSNPI 1962733683
Title
Owner
Phone
(847) 997-2787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA01469300 NJ Primary

Addresses

Primary practice location

7 Centre Dr Ste 9
Monroe, NJ 08831-1565

Mailing address

10 Princeton Ave
Colonia, NJ 07067-2812
Phone (847) 997-2787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170327002370 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2163707548 Receives reassigned benefits from 8 practitioners
Practice locations: Edison, NJ; Monroe, NJ

National Provider Directory

National Provider Directory

Locations

7 Centre Dr
Ste 9
Monroe Twp, NJ 08831
Phone (908) 444-6055

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1043756778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PRINCETON AVE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070672812",
            "telephone_number": "847-997-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CENTRE DR STE 9",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088311565",
            "telephone_number": "908-444-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE SPINE PHYSICAL THERAPY AND YOGA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RUTVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-997-2787",
        "authorized_official_credential": "PT, MS,OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01469300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.