Individual provider Active NPI

Michael Cavallaro, PT, DPT

  • Physical Therapist
  • Cherry Hill, NJ
National Provider Identifier
1114400744
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01854300 Issued in NJ
Practice address
1873 Route 70 E Ste 1-J
Cherry Hill, NJ 08003-2034
Phone
(856) 428-4030
Fax
(856) 428-1093
NPI assigned
Sep 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 40QA01854300 NJ Primary

Addresses

Primary practice location

1873 Route 70 E Ste 1-J
Cherry Hill, NJ 08003-2034

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (888) 830-4125

Other practice location 1

2 Novacare Way
Philadelphia, PA 19145-5900
Phone (267) 546-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01854300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Motive Sports and Physical Therapy, PLLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients

Locations

91 Wilmington W Chester Pike
Ste 28
Chadds Ford, PA 19317
Phone (302) 584-5621

101 Lindenwood Dr
Ste 225
Malvern, PA 19355
Phone (610) 504-4476

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.

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1114400744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 ROUTE 70 E STE 1-J",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032034",
            "telephone_number": "856-428-4030",
            "fax_number": "856-428-1093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Novacare Way",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191455900",
            "country_code": "US",
            "telephone_number": "267-546-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVALLARO",
        "first_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01854300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.