Active NPI
Michael Balcon, DPT
- Physical Therapist
- East Hanover, NJ
National Provider Identifier
1255887246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01676500
- Practice address
- 11 Eagle Rock Ave
Suite 103
East Hanover, NJ 07936-3167 - Phone
- (973) 887-0115
- NPI assigned
- Aug 30, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01676500 | NJ | Primary |
Addresses
Primary practice location
11 Eagle Rock Ave
Suite 103
East Hanover, NJ 07936-3167
Mailing address
11 Eagle Rock Ave
Suite 201
East Hanover, NJ 07936-3167
Phone (973) 887-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01676500 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sportscare Institute, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Toms River, NJ
- NPI 1275501074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472515200000",
"number": "1255887246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 EAGLE ROCK AVE",
"address_2": "SUITE 201",
"city": "EAST HANOVER",
"state": "NJ",
"postal_code": "079363167",
"telephone_number": "973-887-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 EAGLE ROCK AVE",
"address_2": "SUITE 103",
"city": "EAST HANOVER",
"state": "NJ",
"postal_code": "079363167",
"telephone_number": "973-887-0115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALCON",
"first_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-30",
"last_updated": "2016-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01676500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Hanover, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.