Organization Active NPI

At Home Visiting Therapy

  • Physical Therapist
  • Verona, NJ
National Provider Identifier
1245676451
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA01039100 Issued in NJ
Legal business name
AT HOME VISITING THERAPY
Practice address
19 Valhalla Way
Verona, NJ 07044-2328
Phone
(844) 697-8669
NPI assigned
May 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Authorized official

Name
Mary Romain, PT
Title
Owner
Phone
(973) 800-4606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X QA01039100 NJ Primary

Addresses

Primary practice location

19 Valhalla Way
Verona, NJ 07044-2328

Mailing address

49 Union St
Montclair, NJ 07042-3320
Phone (973) 800-4606

Other names 1

  • PT Worx Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131108001869 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153560644 Receives reassigned benefits from 1 practitioner
Practice locations: Verona, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1245676451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 UNION ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423320",
            "telephone_number": "973-800-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 VALHALLA WAY",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070442328",
            "telephone_number": "844-697-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME VISITING THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "ROMAIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-800-4606",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA01039100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PT Worx",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PT Worx",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Verona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.