Individual provider Active NPI

Niva Herzig, MS, PT

  • Physical Therapist
  • Englewood, NJ
National Provider Identifier
1265583637
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01243300 Issued in NJ
Practice address
177 N Dean St
Suite 302
Englewood, NJ 07631-2533
Phone
(201) 568-5060
NPI assigned
Jan 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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 40QA01243300 NJ Primary

Addresses

Primary practice location

177 N Dean St
Suite 302
Englewood, NJ 07631-2533

Mailing address

177 N Dean St
Suite 302
Englewood, NJ 07631-2533
Phone (201) 568-5060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071231000225 NJ Practitioner - Physical Therapist in Private Practice 2062485378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Core Dynamics Physical Therapy, LLCGroup PAC ID 6103906342, 2 clinicians

Practice addresses (Care Compare)

200 Engle St
Suite 20
Englewood, NJ 07631-2417
Phone (201) 568-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
40QA01243300NJMDPhysical Therapist
025692NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Core Dynamics Physical Therapy, LLC CurrentSince Nov 8, 2007 Accepting new patients
Beyond Basics Physical Therapy Physical Therapist PastSince Nov 1, 2011 Accepting new patients

Locations

177 N Dean St
Ste 302
Englewood, NJ 07631
Phone (201) 568-5060

200 Engle St
Ste 20
Englewood, NJ 07631
Phone (201) 568-5060

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": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1265583637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 302",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-568-5060",
            "fax_number": "201-568-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 302",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-568-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZIG",
        "first_name": "NIVA",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01243300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.