Titan Physical Therapy Titan PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Legal business name

TITAN PHYSICAL THERAPY TITAN PT

Practice address

461 US Highway 46
Fairfield, NJ 07004-1954

Phone

(570) 606-5399

NPI assigned

Mar 29, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Mickulik, PT, DPTNPI 1821340399

Title

Physical Therapist, Owner

Phone

(570) 606-5399

Specialties & licenses 1

Addresses

Other names 1

• TITAN Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Mickulik, DPT

  • Physical Therapist
  • Fairfield, NJ
  • NPI 1821340399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1255919684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 HARDING AVE",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122502",
            "telephone_number": "570-606-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 US HIGHWAY 46",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041954",
            "telephone_number": "570-606-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN PHYSICAL THERAPY TITAN PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "MICKULIK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "570-606-5399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TITAN Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TITAN Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Drive Master Co Inc
• The Macaluso Group
• The Therapy Corner
• The Therapy Corner
• Ticounty Spinal Care
• Kirti J Tolia, DDS
• Arthur J Torre, MD
• Douglas A. Torrisi, D.C.
• John Toumanios, D.D.S.
• Christina Trajkoski, PT, DPT

• Orthopedic Physical Therapist in Fairfield, NJ
• Providers in Fairfield, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.