Individual provider Active NPI

Nicholas A Dellavecchia

  • Physical Therapist
  • Mount Laurel, NJ
National Provider Identifier
1225666787
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01919800 Issued in NJ
Practice address
4000 Church Rd
Mount Laurel, NJ 08054-1110
Phone
(856) 281-7500
Fax
(856) 638-5003
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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 40QA01919800 NJ Primary

Addresses

Primary practice location

4000 Church Rd
Mount Laurel, NJ 08054-1110

Mailing address

224 Strawbridge Dr Ste 100
Moorestown, NJ 08057-4602
Phone (856) 677-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200508000947 NJ Practitioner - Physical Therapist in Private Practice 4183055064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Physical Therapy Specialists LLC CurrentSince Jan 1, 2021 Accepting new patients
Strive Physical Therapy Specialists LLC Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients
Strive Physical Therapy Specialists LLC Physical Therapist Past Accepting new patients

Locations

1 Rossmoor Dr
Ste 101
Monroe Twp, NJ 08831
Phone (609) 860-9913

740 Marne Hwy
Ste 203
Moorestown, NJ 08057
Phone (856) 914-1400

224 Strawbridge Dr
Ste 100
Moorestown, NJ 08057
Phone (856) 677-4000

4000 Church Rd
Mount Laurel, NJ 08054
Phone (856) 281-7500

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1225666787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 STRAWBRIDGE DR STE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574602",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541110",
            "telephone_number": "856-281-7500",
            "fax_number": "856-638-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLAVECCHIA",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01919800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; 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.