Organization Active NPI

Functional Performance Institute PC

  • Physical Medicine & Rehabilitation Physician
  • Montville, NJ
National Provider Identifier
1184951501
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
FUNCTIONAL PERFORMANCE INSTITUTE PC
Practice address
2 Changebridge Rd
Unit F
Montville, NJ 07045-8947
Phone
(908) 432-4334
Fax
(908) 469-2638
NPI assigned
Nov 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Authorized official

Name
Dr. Danielle Jean Damelio, DC
Title
President
Phone
(908) 432-4334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

2 Changebridge Rd
Unit F
Montville, NJ 07045-8947

Mailing address

313 South Ave Ste 205
Fanwood, NJ 07023-1364
Phone (908) 288-7049

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130402000322 NJ Part B Supplier - Clinic/Group Practice 0749425312 Receives reassigned benefits from 5 practitioners
Practice locations: Belmar, NJ; Fanwood, NJ; Brick, NJ

National Provider Directory

National Provider Directory

Locations

781 Brick Blvd
Brick, NJ 08723
Phone (732) 428-7472

313 South Ave
Ste 203
Fanwood, NJ 07023
Phone (908) 288-7049

2 Changebridge Rd
Unit G
Montville, NJ 07045
Phone (908) 432-4334

2 Changebridge Rd
#G
Montville, NJ 07045
Phone (908) 432-4334

2 Changebridge Rd
Unit F
Montville, NJ 07045
Phone (908) 432-4334

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1184951501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 SOUTH AVE STE 205",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231364",
            "telephone_number": "908-288-7049",
            "fax_number": "908-288-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHANGEBRIDGE RD",
            "address_2": "UNIT F",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070458947",
            "telephone_number": "908-432-4334",
            "fax_number": "908-469-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL PERFORMANCE INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "DAMELIO",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-432-4334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.