Individual provider Active NPI

Kwaku B Opoku-Nsiah, PT, DPT

  • Physical Therapist
  • East Hanover, NJ
National Provider Identifier
1053741348
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01526500 Issued in NJ
Practice address
11 Eagle Rock Ave
East Hanover, NJ 07936-3167
Phone
(973) 887-9000
NPI assigned
Nov 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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 40QA01526500 NJ Primary

Addresses

Primary practice location

11 Eagle Rock Ave
East Hanover, NJ 07936-3167

Mailing address

530 Kingsland St
Nutley, NJ 07110-1048
Phone (718) 510-3365

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140131000588 NJ Practitioner - Physical Therapist in Private Practice 3274762802 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

110 Edison PL
Suite 100
Newark, NJ 07102-4910
Phone (973) 718-7234

161 Main St
Suite 105
West Orange, NJ 07052-5623
Phone (862) 335-0200

211 Berdan Ave
Wayne, NJ 07470-3236
Phone (201) 249-6930

266 Harristown Rd
Suite 200
Glen Rock, NJ 07452-3354
Phone (201) 445-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Jul 1, 2015 Accepting new patients
Pro Staff Physical Therapy PC Physical Therapist CurrentSince Jun 15, 2022 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince Dec 2, 2013 Accepting new patients
Sportsmed PT LLC Physical Therapist CurrentSince Aug 26, 2025 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1293 Broad St
Bloomfield, NJ 07003
Phone (201) 659-5222

515 Brick Blvd
Brick, NJ 08723
Phone (732) 800-6015

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

935 Allwood Rd
Fl First
Clifton, NJ 07012
Phone (973) 928-3590

11 Eagle Rock Ave
Fl 2
East Hanover, NJ 07936
Phone (973) 887-3000

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

265 Franklin Ave
Nutley, NJ 07110
Phone (973) 661-0500

80 Oak Hill Rd
Red Bank, NJ 07701
Phone (732) 741-2313

Organizations & group practices 5

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": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1053741348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 KINGSLAND ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101048",
            "telephone_number": "718-510-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPOKU-NSIAH",
        "first_name": "KWAKU",
        "middle_name": "B",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01526500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hanover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.