Organization Active NPI

Proheal NJ LLC

  • Physical Therapist
  • Woodbridge, NJ
National Provider Identifier
1104372051
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROHEAL NJ LLC
Practice address
245 Main St
Woodbridge, NJ 07095-1958
Phone
(732) 874-5109
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Purvi ShahNPI 1235400789
Title
Owner
Phone
(732) 704-8109

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 TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

245 Main St
Woodbridge, NJ 07095-1958

Mailing address

245 Main St
Woodbridge, NJ 07095-1958

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170120001483 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6507148863 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbridge, NJ

National Provider Directory

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": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1104372051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951958",
            "telephone_number": "732-874-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEAL NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PURVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-704-8109"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.