Individual provider Active NPI

Victor M Castaneda

  • Physical Therapist
  • Wyckoff, NJ
National Provider Identifier
1164500427
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01011300 Issued in NJ
Practice address
385 Clinton Ave
Wyckoff, NJ 07481-1934
Phone
(201) 848-4599
Fax
(201) 848-6336
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01011300 NJ Primary

Addresses

Primary practice location

385 Clinton Ave
Wyckoff, NJ 07481-1934

Mailing address

138 Hoover Ave
Bloomfield, NJ 07003-3830

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare of America, PC Physical Therapist PastSince Jan 10, 2007 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164500427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 HOOVER AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 CLINTON AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811934",
            "telephone_number": "201-848-4599",
            "fax_number": "201-848-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "VICTOR",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01011300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.