Individual provider Active NPI

Stephen Tawadros, P.T.

  • Physical Therapist
  • Hawthorne, NJ
National Provider Identifier
1083733208
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01117600 Issued in NJ
Practice address
623 Lafayette Ave Ste 101
Hawthorne, NJ 07506-2439
Phone
(201) 647-3669
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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 40QA01117600 NJ Primary

Addresses

Primary practice location

623 Lafayette Ave Ste 101
Hawthorne, NJ 07506-2439

Mailing address

8 Woodland Rd
Montville, NJ 07045-9658
Phone (201) 647-3669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230306002614 NJ Practitioner - Physical Therapist in Private Practice 1951293430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021648NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Health Physical Therapy Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Active Motion Physical Therapy CurrentSince Oct 23, 2022 Accepting new patients
Union Rehabilitation Center PC PastSince Jul 29, 2017 Accepting new patients
Antonelli Chiropractic, P.C. PastSince Oct 20, 2008 Accepting new patients
Comprehensive Orthopedic Physical Therapy Physical Therapist PastSince Apr 30, 2003 Accepting new patients

Locations

623 Lafayette Ave
Ste 101
Hawthorne, NJ 07506
Phone (201) 647-3669

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1083733208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WOODLAND RD",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459658",
            "telephone_number": "201-647-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 LAFAYETTE AVE STE 101",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062439",
            "telephone_number": "201-647-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWADROS",
        "first_name": "STEPHEN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01117600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.