Individual provider Active NPI

Nancy Buckholz

  • Physical Therapist
  • Westwood, NJ
National Provider Identifier
1104841154
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA00518500 Issued in NJ
Practice address
24 Booker Street
Westwood, NJ 07675-2619
Phone
(201) 822-0100
Fax
(201) 822-0107
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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 QA00518500 NJ Primary

Addresses

Primary practice location

24 Booker Street
Westwood, NJ 07675-2619

Mailing address

24 Booker Street
Westwood, NJ 07675-2619
Phone (201) 822-0100

Other identifiers 1

IdentifierTypeStateIssuer
7549915OtherAETNA ID #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060913000339 NJ Practitioner - Physical Therapist in Private Practice 9032113618 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Orthopedic Associates MD PAGroup PAC ID 7810966611, 7 clinicians
Alliance Hand and Physical Therapy, P.C.Group PAC ID 7719883081, 8 clinicians

Practice addresses (Care Compare)

1110 2ND Ave
RM 302
New York, NY 10022-2021
Phone (212) 842-0080

222 Cedar LN
Suite 120
Teaneck, NJ 07666-4311
Phone 2018365332219

28 -32 Van Orden PL
Hackensack, NJ 07601-6011
Phone (201) 621-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA00518500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Hand and Physical Therapy, P.C. Physical Therapist CurrentSince Jun 21, 2006 Accepting new patients
Alliance Hand and Physical Therapy, P.C. CurrentSince Jun 21, 2006 Accepting new patients
Back to Health Physical Therapy Associates, P.a. Physical Therapist CurrentSince Apr 14, 2011 Accepting new patients
Eastern Orthopedic Associates, MD PA CurrentSince Mar 7, 2022 Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Sep 3, 2019 Accepting new patients

Locations

15 Emerald St
Hackensack, NJ 07601
Phone (201) 489-5155

28-32 Van Orden Pl
Hackensack, NJ 07601
Phone (201) 621-0300

1060 Main St
Ste 302
River Edge, NJ 07661
Phone (201) 833-0234

222 Cedar Ln
Ste 120
Teaneck, NJ 07666
Phone (201) 836-5332

24 Booker St
Westwood, NJ 07675
Phone (201) 722-1227

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

Interoperability endpoints

  • FHIR API: https://orthoeast.mmi.prod.fhir.ema-api.com/fhir/r4/

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1104841154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 BOOKER STREET",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752619",
            "telephone_number": "201-822-0100",
            "fax_number": "201-822-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 BOOKER STREET",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752619",
            "telephone_number": "201-822-0100",
            "fax_number": "201-822-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKHOLZ",
        "first_name": "NANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA00518500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID #",
            "identifier": "7549915",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.