Individual provider Active NPI

Marylu Dunn, DPT

  • Orthopedic Physical Therapist
  • Englewood, NJ
National Provider Identifier
1154859684
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
40QA01728000 Issued in NJ
Practice address
15 Nathaniel PL
Englewood, NJ 07631-2735
Phone
(201) 731-8580
Fax
(201) 731-8581
NPI assigned
May 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 40QA01728000 NJ Primary

Addresses

Primary practice location

15 Nathaniel PL
Englewood, NJ 07631-2735

Mailing address

PO Box 416495
Boston, MA 02241-3560
Phone (631) 580-5200

Other practice location 1

75 Montgomery St Fl 501
Jersey City, NJ 07302-3726
Phone (201) 433-6001

Other practice location 2

701 Newark Ave Ste 212
Elizabeth, NJ 07208-3560
Phone (908) 527-6001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824002079 NJ Practitioner - Physical Therapist in Private Practice 3072885177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

15 Nathaniel PL
Englewood, NJ 07631-2735
Phone (201) 731-8580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01728000NJMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network, Inc. Orthopedic CurrentSince Jun 9, 2021 Accepting new patients
Ivyrehab Network Inc. Orthopedic Current Accepting new patients
Ivyrehab Network Inc Orthopedic CurrentSince Jun 9, 2021 Accepting new patients
Dr. Michael C. Stewart, PC Past Accepting new patients

Locations

1436 Route 70 E
Cherry Hill, NJ 08034
Phone (856) 429-8000

15 Nathaniel Pl
Englewood, NJ 07631
Phone (201) 731-8580

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

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.

NPI Registry JSON

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

{
    "created_epoch": "1496016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1154859684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416495",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022413560",
            "telephone_number": "631-580-5200",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 NATHANIEL PL",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312735",
            "telephone_number": "201-731-8580",
            "fax_number": "201-731-8581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Montgomery St Fl 501",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073023726",
            "country_code": "US",
            "telephone_number": "201-433-6001",
            "fax_number": "201-433-6634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Newark Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072083560",
            "country_code": "US",
            "telephone_number": "908-527-6001",
            "fax_number": "908-527-6634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "MARYLU",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-29",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01728000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.

Verify at the official NPI Registry.