Active NPI
Daryl Susan Mitruska, D.C.
- Chiropractor
- Woodbridge, NJ
National Provider Identifier
1104870310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MC04382
- Practice address
- 453 Amboy Ave
Woodbridge, NJ 07095-2960 - Phone
- (732) 324-4300
- Fax
- (732) 324-8211
- NPI assigned
- May 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MC04382 | NJ | Primary |
Addresses
Primary practice location
453 Amboy Ave
Woodbridge, NJ 07095-2960
Mailing address
453 Amboy Ave Ste 1
Woodbridge, NJ 07095-2949
Phone (732) 324-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College - West, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
453 Amboy Ave
Suite 1
Woodbridge, NJ 07095-2949
Phone (732) 324-4300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC04382 | NJ | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Physical Medicine Clinic LLC | Current | Accepting new patients |
Locations
788 Convery Blvd
Perth Amboy, NJ 08861
Phone (732) 324-4300
453 Amboy Ave
Ste 1
Woodbridge, NJ 07095
Phone (732) 324-4300
453 Amboy Ave
Woodbridge, NJ 07095
Phone (732) 388-4184
Organizations & group practices 1
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.
-
- Physical Medicine & Rehabilitation Physician
- Woodbridge, NJ
- NPI 1285922377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767744000000",
"number": "1104870310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 AMBOY AVE STE 1",
"city": "WOODBRIDGE",
"state": "NJ",
"postal_code": "070952949",
"telephone_number": "732-324-4300",
"fax_number": "732-324-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 AMBOY AVE",
"city": "WOODBRIDGE",
"state": "NJ",
"postal_code": "070952960",
"telephone_number": "732-324-4300",
"fax_number": "732-324-8211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITRUSKA",
"first_name": "DARYL",
"middle_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2026-01-07",
"certification_date": "2026-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "MC04382",
"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 Jan 7, 2026; 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.