Individual provider Active NPI

Lawrence Travaglia

  • Physical Therapist
  • Mahwah, NJ
National Provider Identifier
1053709923
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01584600 Issued in NJ
Practice address
300 Route 17
Mahwah, NJ 07430-2141
Phone
(201) 529-8322
Fax
(201) 529-8377
NPI assigned
Dec 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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 40QA01584600 NJ Primary

Addresses

Primary practice location

300 Route 17
Mahwah, NJ 07430-2141

Mailing address

333 Earle Ovington Blvd
Suite 225
Uniondale, NY 11553-3610
Phone (516) 321-2424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150304002301 NJ Practitioner - Physical Therapist in Private Practice 2466778790 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

524 Williamstown Rd
Sicklerville, NJ 08081-1800
Phone (856) 516-0593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients

Locations

300 Route 17
Mahwah, NJ 07430
Phone (201) 529-8322

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

68 River Rd
Summit, NJ 07901
Phone (908) 277-0800

576 Broadhollow Rd
Melville, NY 11747

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": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1053709923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 EARLE OVINGTON BLVD",
            "address_2": "SUITE 225",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115533610",
            "telephone_number": "516-321-2424",
            "fax_number": "516-321-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROUTE 17",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074302141",
            "telephone_number": "201-529-8322",
            "fax_number": "201-529-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVAGLIA",
        "first_name": "LAWRENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01584600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahwah, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.