Active NPI
Michael Wyka, DPT
- Physical Therapist
- Secaucus, NJ
National Provider Identifier
1285399170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02045800
- Practice address
- 150 Flanagan Way
Secaucus, NJ 07094-3445 - Phone
- (201) 992-0166
- NPI assigned
- Nov 4, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 40QA02045800 | NJ | Primary |
Addresses
Primary practice location
150 Flanagan Way
Secaucus, NJ 07094-3445
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
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 |
|---|---|---|---|
| 40QA02045800 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635984000000",
"number": "1285399170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 BROADHOLLOW RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117475002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 FLANAGAN WAY",
"city": "SECAUCUS",
"state": "NJ",
"postal_code": "070943445",
"telephone_number": "201-992-0166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYKA",
"first_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-04",
"last_updated": "2021-11-04",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02045800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Secaucus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.