Maxine Lis, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01619100 Issued in NJ

Practice address

176 Route 70
Suite 37
Medford, NJ 08055-8704

Phone

(609) 714-7733

Fax

(609) 714-7750

NPI assigned

Sep 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maxine Mitjans Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rothman Orthopaedics of New Jersey, LLCGroup PAC ID 6709864846, 175 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.57 of 100Reported as group

Quality

86.68

Promoting interoperability

99

Improvement activities

40

Cost

89.37

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rothman Orthopaedics of New Jersey, LLC

  • Orthopaedic Surgery Physician
  • Marlton, NJ
  • NPI 1215978630
  Medicare reassignment Care Compare group NPD
• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment NPD
• Ivyrehab Network Inc

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1861623753
  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD
• Rothman Institute of New Jersey, P.a.

  • Prosthetic/Orthotic Supplier
  • Manahawkin, NJ
  • NPI 1831611243
  NPD

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1235507039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY",
            "address_2": "STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495249",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 ROUTE 70",
            "address_2": "SUITE 37",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558704",
            "telephone_number": "609-714-7733",
            "fax_number": "609-714-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS",
        "first_name": "MAXINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01619100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXINE",
            "last_name": "MITJANS",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlin Ley, PT, DPT, CSCS
• Despina Lianidis, PA-C
• Ji Young Lim, LPC
• Nicole Lindner, DPT
• Shelby Lion, PT
• Antonio Loccisano Jr., DO
• Luther Lockard, NCTMB
• Louis a D'Angelo, DMD, PC
• Lourdes Medical Associates, PA
• Amy G. Love, M.D.

• Physical Therapist in Medford, NJ
• Providers in Medford, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.