Individual provider Active NPI

Bryan Munoz, PT, DPT, CSCS

  • Physical Therapist
  • Teaneck, NJ
National Provider Identifier
1053765362
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01647500 Issued in NJ
Practice address
646 Kent Ave
Teaneck, NJ 07666-1607
Phone
(201) 692-1727
NPI assigned
Apr 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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 40QA01647500 NJ Primary

Addresses

Primary practice location

646 Kent Ave
Teaneck, NJ 07666-1607

Mailing address

646 Kent Ave
Teaneck, NJ 07666-1607
Phone (201) 692-1727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160923001830 NJ Practitioner - Physical Therapist in Private Practice 7911294640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Teaneck, NJ 07666
Phone (404) 824-7617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01647500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Churchill Orthopedic Rehabilitation, LLC Physical Therapist CurrentSince Aug 8, 2016 Accepting new patients
Balance and Concussion Therapy Center, LLC Physical Therapist CurrentSince Aug 28, 2022 Accepting new patients
BR3 Health & Performance L.L.C. Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Locations

1086 Teaneck Rd
Ste 3E
Teaneck, NJ 07666
Phone (201) 575-6291

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1053765362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 KENT AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661607",
            "telephone_number": "201-692-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 KENT AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661607",
            "telephone_number": "201-692-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01647500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.