Michelle Ribustello, PT, DPT
Individual provider Active NPI Physical Therapist · Northvale, NJ
NPI 1104226372 · NPPES record last updated Aug 25, 2014
Key facts
- NPI
- 1104226372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA01329600 (NJ)
- Practice address
- 220 Livingston St
#112
Northvale, NJ 07647-1738 - Phone
- (201) 564-7515
- NPI assigned
- Aug 25, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jewish Home Assisted Living
Practice addresses (Care Compare)
685 Westwood Ave
River Vale, NJ 07675-6335
Phone (201) 666-2370
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150327000987 | NJ | Practitioner - Physical Therapist in Private Practice | 1254658446 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jewish Home Assisted Living | Physical Therapist | Current |
Accepting new patients |
Locations
685 Westwood Ave
River Vale, NJ 07675
Phone (201) 478-4260
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01329600 | NJ | Yes |
Addresses
Primary practice location
220 Livingston St
#112
Northvale, NJ 07647-1738
Mailing address
220 Livingston St
#112
Northvale, NJ 07647-1738
Phone (201) 564-7515
NPI Registry JSON
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408924800000",
"number": "1104226372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 LIVINGSTON ST",
"address_2": "#112",
"city": "NORTHVALE",
"state": "NJ",
"postal_code": "076471738",
"telephone_number": "201-564-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 LIVINGSTON ST",
"address_2": "#112",
"city": "NORTHVALE",
"state": "NJ",
"postal_code": "076471738",
"telephone_number": "201-564-7515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIBUSTELLO",
"first_name": "MICHELLE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01329600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northvale, NJ
- Nicole Pesce
- Peter Ahn Chiropractic NJ P.C
- Pure Dental LLC
- Pure Wellness Medical PLLC
- Anilaja Muppidi Reddy
- Dawn Marie Rivera
- Livia Rosca
- Michelle Rosenberg
- Joel David Rosenkrantz
- Jasmeet Sandhu
All providers in Northvale, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.