Daniel Villavicencio, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01999100 Issued in NJ

Practice address

1071 Inman Ave Unit 4
Edison, NJ 08820-1132

Phone

(732) 518-8868

Fax

(732) 719-6080

NPI assigned

Apr 24, 2021

Last updated

Jan 18, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment NPD
• Sportsmed PT LLC

  • Physical Therapist
  • Glen Rock, NJ
  • NPI 1841787645
  Medicare reassignment NPD
• Apex Home Therapy LLC

  • Physical Therapist
  • Freehold, NJ
  • NPI 1861966129
  Medicare reassignment
• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246
  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1083296545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 INMAN AVE UNIT 4",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201132",
            "telephone_number": "732-518-8868",
            "fax_number": "732-719-6080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Timberline Rd",
            "address_purpose": "LOCATION",
            "city": "Bayville",
            "state": "NJ",
            "postal_code": "087212171",
            "country_code": "US",
            "telephone_number": "732-300-6536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "DANIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-24",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01999100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Anthony Vidolin, DMD
• Prateek Vijay, D.O.
• Noemi H Villacis, M.A., CCC-SLP
• Leslie Villacorta
• Maria Isabel Villar, MSW
• Mara Vilme
• Michael P Vira, PHARMD
• Stefania A. Virone, PA-C
• Virtue Care Inc
• Virtue Care Inc

• Physical Therapist in Edison, NJ
• Providers in Edison, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.