Organization Active NPI

Accelerated Rehab & Pain Management PA

  • Physical Medicine & Rehabilitation Physician
  • Parsippany, NJ
National Provider Identifier
1063746527
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
235083 Issued in NY
Legal business name
ACCELERATED REHAB & PAIN MANAGEMENT PA
Practice address
1279 Route 46
Parsippany, NJ 07054-4904
Phone
(973) 794-4704
Fax
(973) 794-4707
NPI assigned
Sep 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Authorized official

Name
Katie Bolen
Title
Manager
Phone
(973) 794-4704

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X 25MA07658100 NJ
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X 235083 NY
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 235083 NY Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 25MA07658100 NJ
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 25MA07658100 NJ
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 235083 NY
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 25MA07658100 NJ
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 235083 NY

Addresses

Primary practice location

1279 Route 46
Parsippany, NJ 07054-4904

Mailing address

PO Box 4405
Clifton, NJ 07012-8405
Phone (973) 794-4704

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100330000861 NJ Part B Supplier - Clinic/Group Practice 3779619648 Receives reassigned benefits from 1 practitioner
Practice locations: Turnersville, NJ; Paterson, NJ; North Brunswick, NJ; Neptune City, NJ; Parsippany, NJ

National Provider Directory

National Provider Directory

Locations

1089 Elizabeth Ave
Elizabeth, NJ 07201
Phone (908) 469-6363

70 Ridge Rd
Lyndhurst, NJ 07071
Phone (201) 933-4775

61 Morris Ave
Neptune City, NJ 07753
Phone (732) 456-6337

1279 Route 46
Ste 1
Parsippany, NJ 07054

403 Commerce Ln
#1
West Berlin, NJ 08091

23059 Rockaway Blvd
Ofc
Jamaica, NY 11413

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1063746527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4405",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070128405",
            "telephone_number": "973-794-4704",
            "fax_number": "973-794-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 ROUTE 46",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070544904",
            "telephone_number": "973-794-4704",
            "fax_number": "973-794-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCELERATED REHAB & PAIN MANAGEMENT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "BOLEN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-794-4704"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NJ",
            "license": "25MA07658100",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "235083",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "235083",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA07658100",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "25MA07658100",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "235083",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA07658100",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "235083",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.