Individual provider Active NPI

Rebecca Callahan

  • Physical Therapist
  • Paterson, NJ
National Provider Identifier
1205223302
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01595300 Issued in NJ
Practice address
922 Main St
Ste 101
Paterson, NJ 07503-2602
Phone
(973) 345-8200
Fax
(973) 345-9590
NPI assigned
Apr 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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 40QA01595300 NJ Primary

Addresses

Primary practice location

922 Main St
Ste 101
Paterson, NJ 07503-2602

Mailing address

922 Main St
Suite 101
Paterson, NJ 07503-2602

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526000244 NJ Practitioner - Physical Therapist in Private Practice 1759601255 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01595300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Staff Physical Therapy PC Physical Therapist CurrentSince Aug 1, 2016 Accepting new patients
Twin Boro Physical Therapy Associates, PA CurrentSince Dec 1, 2022 Accepting new patients
Twin Boro Physical Therapy Associates PA Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

935 Allwood Rd
Fl First
Clifton, NJ 07012
Phone (973) 928-3590

20 Commerce Dr
Ste 210
Cranford, NJ 07016

2050 State Route 27
Ste 107
North Brunswick, NJ 08902
Phone (732) 745-2727

265 Franklin Ave
Nutley, NJ 07110
Phone (973) 661-0500

Organizations & group practices 3

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": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1205223302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 MAIN ST",
            "address_2": "SUITE 101",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 MAIN ST",
            "address_2": "STE 101",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032602",
            "telephone_number": "973-345-8200",
            "fax_number": "973-345-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01595300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.