Active NPI
Mohamed Wyell Tarakji, PT, DPT
- Physical Therapist
- Newton, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02284500
- Practice address
- 280 Newton Sparta Rd Ste 8
Newton, NJ 07860-2775 - Phone
- (973) 494-7774
- NPI assigned
- Aug 29, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA02284500 | NJ | Primary |
Addresses
Primary practice location
280 Newton Sparta Rd Ste 8
Newton, NJ 07860-2775
Mailing address
10 Netcong HTS Apt 6
Netcong, NJ 07857-1710
Phone (973) 580-8643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
80 Mill St
Suite 1
Newton, NJ 07860-1411
Phone (973) 940-7311
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA02284500 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Network Inc. | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Network Inc | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Network, Inc. | Physical Therapist | Current | Accepting new patients |
| Melip Enterprises | Physical Therapist | Current | Accepting new patients |
Locations
731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780
454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905
80 Mill St
#1
Newton, NJ 07860
Phone (973) 940-7311
280 Newton Sparta Rd
Ste 8
Newton, NJ 07860
Phone (973) 579-2957
104 Main St
Ste 1A
Sparta, NJ 07871
Phone (973) 729-1222
Organizations & group practices 4
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 Therapist
- Hoboken, NJ
- NPI 1174577274
-
- Physical Therapist
- Sparta, NJ
- NPI 1104585264
-
- Physical Therapist
- Hoboken, NJ
- NPI 1861623753
-
- Physical Medicine & Rehabilitation Physician
- Cranford, NJ
- NPI 1699590265
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1124852496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 NETCONG HTS APT 6",
"city": "NETCONG",
"state": "NJ",
"postal_code": "078571710",
"telephone_number": "973-580-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 NEWTON SPARTA RD STE 8",
"city": "NEWTON",
"state": "NJ",
"postal_code": "078602775",
"telephone_number": "973-494-7774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARAKJI",
"first_name": "MOHAMED",
"middle_name": "WYELL",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-29",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02284500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.