NPIMap

Organization Active NPI

Theraphysical, LLC

  • Physical Therapy Clinic/Center
  • Lyndhurst, NJ
National Provider Identifier
1134463235
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
40QA01383800 Issued in NJ
Legal business name
THERAPHYSICAL, LLC
Practice address
623 Ridge Rd
Lyndhurst, NJ 07071-3205
Phone
(201) 340-4656
Fax
(201) 340-4580
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Dr. Magdalena Buczek
Title
DPT
Phone
(201) 340-4656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA01383800 NJ Primary

Addresses

Primary practice location

623 Ridge Rd
Lyndhurst, NJ 07071-3205

Mailing address

623 Ridge Rd
Lyndhurst, NJ 07071-3205
Phone (201) 340-4656

Other practice location 1

118 Outwater Ln
Garfield, NJ 07026-2629
Phone (201) 340-4656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121211000035 NJ Part B Supplier - Clinic/Group Practice 4981856341 Receives reassigned benefits from 21 practitioners
Practice locations: Wallington, NJ; Lyndhurst, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

518 Stuyvesant Ave
Ste 200
Lyndhurst, NJ 07071

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1134463235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 RIDGE RD",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070713205",
            "telephone_number": "201-340-4656",
            "fax_number": "201-340-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 RIDGE RD",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070713205",
            "telephone_number": "201-340-4656",
            "fax_number": "201-340-4580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Outwater Ln",
            "address_purpose": "LOCATION",
            "city": "Garfield",
            "state": "NJ",
            "postal_code": "070262629",
            "country_code": "US",
            "telephone_number": "201-340-4656",
            "fax_number": "201-340-4580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPHYSICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "BUCZEK",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_title_or_position": "DPT",
        "authorized_official_telephone_number": "201-340-4656",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01383800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.