Individual provider Active NPI

Maribeth Grella

  • Physical Therapist
  • Succasunna, NJ
National Provider Identifier
1255768453
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00711000 Issued in NJ
Practice address
118 Main St
Succasunna, NJ 07876-1385
Phone
(973) 584-4000
Fax
(973) 933-4510
NPI assigned
Oct 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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 40QA00711000 NJ Primary

Addresses

Primary practice location

118 Main St
Succasunna, NJ 07876-1385

Mailing address

401 Ridge Rd
Suite1
Dayton, NJ 08810-3300
Phone (732) 230-3076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140102000901 NJ Practitioner - Physical Therapist in Private Practice 2668600313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00711000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Apr 20, 2018 Accepting new patients
Imperial Vista Health Care Staffing, LLC Physical Therapist Past Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

7 Carnegie Plz
Cherry Hill, NJ 08003

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

Organizations & group practices 2

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": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1255768453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RIDGE RD",
            "address_2": "SUITE1",
            "city": "DAYTON",
            "state": "NJ",
            "postal_code": "088103300",
            "telephone_number": "732-230-3076",
            "fax_number": "866-862-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN ST",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761385",
            "telephone_number": "973-584-4000",
            "fax_number": "973-933-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRELLA",
        "first_name": "MARIBETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00711000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Succasunna, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.