Individual provider Active NPI

Amita Mali, MSPT

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1114203163
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01469900 Issued in NJ
Practice address
2147 Route 27
Edison, NJ 08817-3365
Phone
(732) 777-9733
Fax
(732) 777-9730
NPI assigned
Oct 21, 2011
Last updated
Nov 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 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 40QA01469900 NJ Primary

Addresses

Primary practice location

2147 Route 27
Edison, NJ 08817-3365

Mailing address

247 3Rd St
Apt-3
Jersey City, NJ 07302-2803
Phone (303) 324-4763

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171121002365 NJ Practitioner - Physical Therapist in Private Practice 6709143001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Jogo Physical TherapyGroup PAC ID 3274982863, 4 clinicians

Practice addresses (Care Compare)

2204 Route 18 N
Old Bridge, NJ 08857-3473
Phone (551) 655-7793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01469900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Jogo Physical Therapy Physical Therapist CurrentSince Feb 24, 2024 Accepting new patients
Jersey Central Physical Therapy Past Accepting new patients

Locations

2204 State Route 18 N
Old Bridge, NJ 08857
Phone (551) 655-7793

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1114203163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 3RD ST",
            "address_2": "APT-3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022803",
            "telephone_number": "303-324-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 ROUTE 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173365",
            "telephone_number": "732-777-9733",
            "fax_number": "732-777-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALI",
        "first_name": "AMITA",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01469900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.