NPIMap

Organization Active NPI

Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
National Provider Identifier
1174577274
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IVYREHAB NETWORK INC.
Practice address
79 Hudson St
Hoboken, NJ 07030-5602
Phone
(201) 792-1170
Fax
(201) 792-1171
NPI assigned
May 22, 2006
Last updated
Aug 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Michael Rucker
Title
Ceo
Phone
(914) 777-8700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X NJ

Addresses

Primary practice location

79 Hudson St
Hoboken, NJ 07030-5602

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628000865 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3476539776 Receives reassigned benefits from 824 practitioners
1 other NPI on this enrollment

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ivyrehab Network Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations (25 of 113)

167 Us Hwy 9
Boston, MA 02241

130 Black Horse Pike
Ste 312
Audubon, NJ 08106

1600 Saint Georges Ave
Ste A
Avenel, NJ 07001

434 Broadway
Bayonne, NJ 07002
Phone (201) 436-1664

15 Newark Ave
#1
Belleville, NJ 07109

15 Newark Ave
Ste A
Belleville, NJ 07109
Phone (973) 759-1100

77 Newark Ave
Ste A
Belleville, NJ 07109
Phone (973) 759-1100

217 US Highway 130
Bordentown, NJ 08505
Phone (609) 400-1630

243 US Highway 130
Ste 100
Bordentown, NJ 08505
Phone (609) 400-1630

34 Lanes Mill Rd
Unit 2A
Brick, NJ 08724

34 Lanes Mill Rd
Unit 2A2B
Brick, NJ 08724
Phone (732) 714-6363

74 Brick Blvd
Bldg 4
Brick, NJ 08723
Phone (732) 451-0010

70 Manheim Ave
Ste 3
Bridgeton, NJ 08302
Phone (856) 455-9700

178 E Hanover Ave
Ste A11
Cedar Knolls, NJ 07927

650 Shunpike Rd
Ste 10
Chatham, NJ 07928

1873 Route 70 E
Ste 1-J
Cherry Hill, NJ 08003
Phone (856) 428-4030

2005 Route 70 E
Cherry Hill, NJ 08003
Phone (609) 714-7733

95 W Main St
Ste 6
Chester, NJ 07930
Phone (908) 879-7364

23204 Columbus Rd
#2
Columbus, NJ 08022

123 E Main St
Ste 4
Denville, NJ 07834
Phone (973) 625-0744

3155 State Route 10
Ste 8
Denville, NJ 07834
Phone (856) 519-5780

1692 Clements Bridge Rd
Ste K
Deptford, NJ 08096

300 Princeton Hightstown Rd
East Windsor, NJ 08520
Phone (609) 426-9200

300A Princeton Hightstown Rd
Ste 201
East Windsor, NJ 08520
Phone (609) 426-4442

1071 Inman Ave
Unit 4
Edison, NJ 08820
Phone (732) 518-8868

Practitioners & affiliated clinicians

Practitioners 946

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 946

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1174577274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 HUDSON ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305602",
            "telephone_number": "201-792-1170",
            "fax_number": "201-792-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVYREHAB NETWORK INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "914-777-8700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.