NPIMap

Organization Active NPI

Back to Health Physical Therapy Associates, P.a.

  • Physical Therapist
  • Teaneck, NJ
National Provider Identifier
1174712178
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01108500 Issued in NJ
Legal business name
BACK TO HEALTH PHYSICAL THERAPY ASSOCIATES, P.A.
Practice address
316 Maitland Ave
Teaneck, NJ 07666-3025
Phone
(201) 833-0234
NPI assigned
Oct 16, 2007
Last updated
Oct 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Authorized official

Name
Mitchell Simpson, PT,MS,OCSNPI 1346346293
Title
President
Phone
(201) 833-0234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01108500 NJ Primary

Addresses

Primary practice location

316 Maitland Ave
Teaneck, NJ 07666-3025

Mailing address

316 Maitland Ave
Teaneck, NJ 07666-3025
Phone (201) 833-0234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060424000017 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1456361302 Receives reassigned benefits from 30 practitioners
Practice locations: River Edge, NJ

National Provider Directory

National Provider Directory

Locations

1060 Main St
Ste 302
River Edge, NJ 07661
Phone (201) 833-0234

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1174712178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MAITLAND AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663025",
            "telephone_number": "201-833-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAITLAND AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663025",
            "telephone_number": "201-833-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO HEALTH PHYSICAL THERAPY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-833-0234",
        "authorized_official_credential": "PT,MS,OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01108500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.