Stella Dimitrakakis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01346800 Issued in NJ

Practice address

1000 Galloping Hill Rd Ste 203
Union, NJ 07083-7989

Phone

(908) 522-6420

NPI assigned

Mar 25, 2010

Last updated

Apr 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Soma Vita Physio & Wellness LLC

  • Physical Therapy Clinic/Center
  • Watchung, NJ
  • NPI 1154055143
  NPD Authorized official

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1114241718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GALLOPING HILL RD STE 203",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837989",
            "telephone_number": "908-522-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GALLOPING HILL RD STE 203",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837989",
            "telephone_number": "908-522-6420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 Park Ave",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088202562",
            "country_code": "US",
            "telephone_number": "732-494-0895",
            "fax_number": "732-494-0896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMITRAKAKIS",
        "first_name": "STELLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01346800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY BOARD OF PHYSICAL THERAPY",
            "identifier": "40QA01330500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nereida Diaz-Johnson, M.D.
• Digiacomo Medical Associates LLC
• William Arthur Digiacomo, M.D.,F.A.C.P.
• William Scott Digiacomo, M.D.
• Digitrace Care Services, Inc.
• Veronica Carmen Dinu, MD
• Julie Dirico, MD
• Divine Mental Healthcare Services
• Divine Restorators Psychiatric Services
• Raymond N. Divirgilio

• Physical Therapist in Union, NJ
• Providers in Union, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.