Individual provider Active NPI

William Elbert, PTA

  • Physical Therapy Assistant
  • East Rutherford, NJ
National Provider Identifier
1275962177
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00289000 Issued in NJ
Practice address
341 Railroad Ave
East Rutherford, NJ 07073-1717
Phone
(201) 438-7189
Fax
(201) 438-7174
NPI assigned
Nov 1, 2013
Last updated
Nov 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00289000 NJ Primary

Addresses

Primary practice location

341 Railroad Ave
East Rutherford, NJ 07073-1717

Mailing address

341 Railroad Ave
East Rutherford, NJ 07073-1717

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QB00289000NJMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raising the Bar Rehabilitation and Fitness LLC PastSince Feb 1, 2012 Accepting new patients
Professional Advantage Nutrition and Fitness, LLC PastSince Sep 1, 2012 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1275962177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 RAILROAD AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 RAILROAD AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731717",
            "telephone_number": "201-438-7189",
            "fax_number": "201-438-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBERT",
        "first_name": "WILLIAM",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00289000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rutherford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.