Individual provider Active NPI

Cesar Valente Garduque Jr., OTR

  • Occupational Therapist
  • Hackensack, NJ
National Provider Identifier
1104060268
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013016 Issued in NY
Practice address
54 Polifly Rd Apt 311
Hackensack, NJ 07601-3295
Phone
(646) 206-1025
Fax
(201) 880-0614
NPI assigned
Apr 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 013016 NY Primary

Addresses

Primary practice location

54 Polifly Rd Apt 311
Hackensack, NJ 07601-3295

Mailing address

54 Polifly Rd Apt 311
Hackensack, NJ 07601-3295
Phone (646) 206-1025

Other identifiers 2

IdentifierTypeStateIssuer
46TR00447800OtherNJNJ STATE LICENSE
013016OtherNYNYSED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210628000234 NJ Practitioner - Occupational Therapist in Private Practice 5395146484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Link Home Services of NJ LLCGroup PAC ID 9133551765, 45 clinicians

Practice addresses (Care Compare)

Englewood Cliffs, NJ 07632
Phone (718) 650-6230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013016NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Occupational Therapist CurrentSince Jul 9, 2022 Accepting new patients
PT on the Go PC CurrentSince Aug 8, 2021 Accepting new patients
Link Home Services of NJ LLC CurrentSince Aug 15, 2021 Accepting new patients
Homeside Rehab, PT, OT, SLP LLC CurrentSince Jul 25, 2021 Accepting new patients

Locations

516 Sylvan Ave
Englewood Cliffs, NJ 07632

180 Sylvan Ave
Ste 401
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436

296 Route 59
Ste 1225
Suffern, NY 10901

Organizations & group practices 4

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1104060268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 POLIFLY RD APT 311",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013295",
            "telephone_number": "646-206-1025",
            "fax_number": "201-880-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 POLIFLY RD APT 311",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013295",
            "telephone_number": "646-206-1025",
            "fax_number": "201-880-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDUQUE",
        "first_name": "CESAR",
        "middle_name": "VALENTE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE LICENSE",
            "identifier": "46TR00447800",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYSED",
            "identifier": "013016",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.