Michael D. Devito, PT
Individual provider Active NPI Physical Therapist · Dumont, NJ
NPI 1194036863 · NPPES record last updated Jul 27, 2010
Key facts
- NPI
- 1194036863
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA00547400 (NJ)
- Practice address
- 35 Oneida Ave
Dumont, NJ 07628-2109 - Phone
- (201) 723-9986
- NPI assigned
- Jun 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101214000245 | NJ | Practitioner - Physical Therapist in Private Practice | 8527255751 |
Reassigns benefits to 1 organization Practice locations: Dumont, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00547400 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Rehab Consultants, LLC | Physical Therapist | Current |
Accepting new patients |
| Axis Physical Therapy, LLC | Physical Therapist | Past |
Accepting new patients |
Locations
617 Oradell Ave
Unit 9
Oradell, NJ 07649
Phone (201) 661-0811
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00547400 | NJ | Yes |
Addresses
Primary practice location
35 Oneida Ave
Dumont, NJ 07628-2109
Mailing address
35 Oneida Ave
Dumont, NJ 07628-2109
Phone (201) 723-9986
Other providers in Dumont, NJ
- Thea Omega Jardiniano Dela Cuesta
- Courtney Ann Deloughery
- Christie A Demarest
- Xelenia Depena
- Philippe Desplat
- Sean Donellan
- Dream Dental Associates
- Dumont Board of Education
- Daniel Eidman
- Stephanie Nicole Eisele
All providers in Dumont, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.