Aditi Chandan, DPT
Individual provider Active NPI Physical Therapist · Mountainside, NJ
NPI 1114304359 · NPPES record last updated May 3, 2021
Key facts
- NPI
- 1114304359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 035095 (NY)
- Practice address
- 1111 US Highway 22
Mountainside, NJ 07092-2814 - Phone
- (908) 389-9100
- NPI assigned
- Apr 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Innovative Jogo Physical Therapy
Practice addresses (Care Compare)
2204 Route 18 N
Old Bridge, NJ 08857-3473
Phone (551) 655-7793
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210519000380 | NJ | Practitioner - Physical Therapist in Private Practice | 1557611571 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01968900 | NJ | MD | Physical Therapist |
| 1223018 | TX | MD | Physical Therapist |
| 035095 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Physical Therapy and Fitness Center Inc | Physical Therapist | Current |
Accepting new patients |
| Innovative Physical Therapy and Fitness Center Inc | Physical Therapist | Current |
Accepting new patients |
Locations
3562 State Route 27
Ste 124
Kendall Park, NJ 08824
Phone (732) 317-4105
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1223018 | TX | |
| Physical Therapist | 225100000X | 035095 | NY | Yes |
| Physical Therapist | 225100000X | 40QA01968900 | NJ |
Addresses
Primary practice location
1111 US Highway 22
Mountainside, NJ 07092-2814
Mailing address
1111 US Highway 22
Mountainside, NJ 07092-2814
Phone (908) 389-9100
Other practice location 1
6601 Harris Pkwy
Fort Worth, TX 76132
Phone (817) 433-9742
Other providers in Mountainside, NJ
- Catalyst Physical Therapy & Wellness
- Jessica Cavanagh
- Center for Ambulatory Surgery, LLC
- Maria Corazon Cerdena
- Melissa Cerimele
- Goda Devi Chari
- Children' Specialized Hospital
- Children'S Specialized Hospital
- Childrens Specialized Hospital
- Childrens Specialized Hospital
All providers in Mountainside, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.