Meadowlands Physical Therapy and Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01451600 Issued in NJ

Legal business name

MEADOWLANDS PHYSICAL THERAPY AND WELLNESS

Practice address

510 Palisade Ave Apt 3R
Jersey City, NJ 07307-1412

Phone

(201) 655-8246

NPI assigned

Jun 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Konstantinos Mavropoulos, PT, DPTNPI 1811243512

Title

Owner/Physical Therapist

Phone

(201) 655-8246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Konstantinos Mavropoulos, PT, DPT, FAAOMPT

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1811243512
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1245724442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WASHINGTON ST # 254",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PALISADE AVE APT 3R",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073071412",
            "telephone_number": "201-655-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWLANDS PHYSICAL THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "MAVROPOULOS",
        "authorized_official_first_name": "KONSTANTINOS",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "201-655-8246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01451600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Jersey City, NJ
• Providers in Jersey City, 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 Dec 11, 2024; 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.