Organization Active NPI

Maywood in Motion Physical Therapy and Wellness

  • Physical Therapist
  • Maywood, NJ
National Provider Identifier
1104662659
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAYWOOD IN MOTION PHYSICAL THERAPY AND WELLNESS
Practice address
37 Brook Ave
Maywood, NJ 07607-1130
Phone
(973) 572-5645
NPI assigned
Jul 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Nisha Shah, PTNPI 1154671881
Title
Owner/Physical Therapist
Phone
(973) 572-5645

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: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

37 Brook Ave
Maywood, NJ 07607-1130

Mailing address

37 Brook Ave
Maywood, NJ 07607-1130
Phone (973) 572-5645

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240913003211 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496295651 Receives reassigned benefits from 2 practitioners
Practice locations: Maywood, NJ

National Provider Directory

National Provider Directory

Locations

300 Broadacres Dr
Ste 126C
Bloomfield, NJ 07003

37 Brook Ave
Ste 100
Maywood, NJ 07607

Practitioners & affiliated clinicians

Practitioners 2

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": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1104662659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BROOK AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071130",
            "telephone_number": "973-572-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BROOK AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071130",
            "telephone_number": "973-572-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYWOOD IN MOTION PHYSICAL THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "NISHA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-572-5645",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.