Organization Active NPI

Forest Hill Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Newark, NJ
National Provider Identifier
1083102602
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FOREST HILL PHYSICAL THERAPY LLC
Practice address
465 Mt Prospect Ave
Newark, NJ 07104
Phone
(973) 485-4766
Fax
(973) 732-1141
NPI assigned
Apr 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Marvin P. Royal II, MDNPI 1841224839
Title
Clinical Director
Phone
(973) 485-4766

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 Primary

Addresses

Primary practice location

465 Mt Prospect Ave
Newark, NJ 07104

Mailing address

465 Mt Prospect Ave.
Newark, NJ 07104
Phone (973) 485-4766

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180924002239 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2466703822 Receives reassigned benefits from 1 practitioner
Practice locations: Newark, NJ

National Provider Directory

National Provider Directory
Tax ID family
Forest Hill Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1083102602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 MT PROSPECT AVE.",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07104",
            "telephone_number": "973-485-4766",
            "fax_number": "973-732-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07104",
            "telephone_number": "973-485-4766",
            "fax_number": "973-732-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HILL PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "ROYAL",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "973-485-4766",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.