Active NPI
Brianna Peterson
- Physical Therapist
- Montclair, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02110100
- Practice address
- 1 Greenwood Ave
Montclair, NJ 07042-3649 - Phone
- (973) 813-1735
- NPI assigned
- Aug 30, 2022
- Sex
- Female
- 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 | 40QA02110100 | NJ | Primary |
Addresses
Primary practice location
1 Greenwood Ave
Montclair, NJ 07042-3649
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Northeastern Ohio University College of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Greenwood Ave
Montclair, NJ 07042-3649
Phone (973) 746-2424
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
Locations
1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424
524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591
524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564
576 Broadhollow Rd
Melville, NY 11747
Organizations & group practices 3
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.
-
- Occupational Therapist
- Sicklerville, NJ
- NPI 1215487772
Physical Therapist
-
- Occupational Therapist
- Randolph, NJ
- NPI 1104376680
Physical Therapist
-
- Occupational Therapist
- Whitestone, NY
- NPI 1487104261
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1295455293",
"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",
"telephone_number": "631-359-5859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GREENWOOD AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070423649",
"telephone_number": "973-813-1735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "BRIANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-30",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02110100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.