NPIMap

Organization Active NPI

Elite Spine and Sports Care of Totowa

  • Physical Therapy Clinic/Center
  • Totowa, NJ
National Provider Identifier
1306231527
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ELITE SPINE AND SPORTS CARE OF TOTOWA
Practice address
351 Union Blvd
Totowa, NJ 07512-2556
Phone
(862) 239-1768
NPI assigned
Apr 3, 2015
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Gabriel Hannawi, D.C.NPI 1013332055
Title
Owner/Director
Phone
(862) 239-1768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Chiropractor 111N00000X 38MC00715100 NJ
Physical Therapist 225100000X 40QA01425800 NJ
Occupational Therapist 225X00000X

Addresses

Primary practice location

351 Union Blvd
Totowa, NJ 07512-2556

Mailing address

PO Box 688
Totowa, NJ 07511-0688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150622001192 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779894415 Receives reassigned benefits from 9 practitioners
Practice locations: Totowa, NJ

National Provider Directory

National Provider Directory

Locations

351 Union Blvd
Totowa, NJ 07512
Phone (201) 563-7095

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1306231527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 688",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075110688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122556",
            "telephone_number": "862-239-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPINE AND SPORTS CARE OF TOTOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "HANNAWI",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "862-239-1768",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00715100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01425800",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.