Active NPI
Suzanne E Wagner
- Physical Therapist
- Union City, NJ
National Provider Identifier
1154490167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00841500
- Practice address
- 3196 JF Kennedy Blvd
3Rd Floor
Union City, NJ 07087 - Phone
- (201) 223-9797
- Fax
- (973) 223-9722
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- 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 | 40QA00841500 | NJ | Primary |
Addresses
Primary practice location
3196 JF Kennedy Blvd
3Rd Floor
Union City, NJ 07087
Mailing address
265 Oak Ridge Ave
Summit, NJ 07901-3258
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00841500 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportscare Institute, Inc. | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Toms River, NJ
- NPI 1275501074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1154490167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 OAK RIDGE AVE",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "079013258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3196 JF KENNEDY BLVD",
"address_2": "3RD FLOOR",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "07087",
"telephone_number": "201-223-9797",
"fax_number": "973-223-9722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "SUZANNE",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00841500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.