Dustin Koykas, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00355500 Issued in NJ

Practice address

220 Livingston St Ste 112
Northvale, NJ 07647-1739

Phone

(201) 564-7515

NPI assigned

Sep 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dynamic Physical Therapy and Sports Rehabilitations

  • Physical Therapy Clinic/Center
  • Northvale, NJ
  • NPI 1891017034
  NPD (past)

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1225513286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 LIVINGSTON ST STE 112",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076471739",
            "telephone_number": "201-564-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LIVINGSTON ST STE 112",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076471739",
            "telephone_number": "201-564-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOYKAS",
        "first_name": "DUSTIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00355500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Jalowiecki Sullivan, THERAPIST EDUCATOR
• Joel D. Rosenkrantz, DDS, LLC
• Kbradley Whole Nutrition LLC
• Jong Seok Kim
• Miriam Kim, MSN AGPCNP-BC CCRN
• Shyam Kunadia
• Ethan Lizarraga, MD
• Nancy Lorenzini, BCBA
• LP Dental Group LLC
• Colleen A McGuirl, LCSW, LCADC

• Physical Therapy Assistant in Northvale, NJ
• Providers in Northvale, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.