NPIMap

Organization Active NPI

Tawil Physical Therapy and Sports Performance, PA

  • Physical Therapist
  • North Bergen, NJ
National Provider Identifier
1235474156
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00985500 Issued in NJ
Legal business name
TAWIL PHYSICAL THERAPY AND SPORTS PERFORMANCE, PA
Practice address
8701 Kennedy Blvd
North Bergen, NJ 07047-4387
Phone
(201) 552-9072
Fax
(201) 552-9073
NPI assigned
Dec 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Authorized official

Name
Dr. Michelle Tawil, DPTNPI 1497824163
Title
President/Owner
Phone
(201) 394-9004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 40QA00985500 NJ Primary

Addresses

Primary practice location

8701 Kennedy Blvd
North Bergen, NJ 07047-4387

Mailing address

8701 Kennedy Blvd
North Bergen, NJ 07047-4387
Phone (201) 552-9072

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121220000398 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9032361092 Receives reassigned benefits from 4 practitioners
Practice locations: North Bergen, NJ

National Provider Directory

National Provider Directory

Locations

8701 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 552-9072

Practitioners & affiliated clinicians

Practitioners 4

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": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1235474156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070474387",
            "telephone_number": "201-552-9072",
            "fax_number": "201-552-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070474387",
            "telephone_number": "201-552-9072",
            "fax_number": "201-552-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAWIL PHYSICAL THERAPY AND SPORTS PERFORMANCE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "TAWIL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "201-394-9004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00985500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.