Organization Active NPI

Rehab Medicine

  • Physical Medicine & Rehabilitation Physician
  • Wayne, NJ
National Provider Identifier
1316411440
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REHAB MEDICINE
Practice address
510 Hamburg Tpke Ste 107
Wayne, NJ 07470-2033
Phone
(973) 559-3760
NPI assigned
Jan 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Anthony Doss, MDNPI 1750775987
Title
Owner
Phone
(973) 559-3760

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

510 Hamburg Tpke Ste 107
Wayne, NJ 07470-2033

Mailing address

75 Bourbon St
Wayne, NJ 07470-5492

Other practice location 1

1700 State Rt 3 Ste 5
Clifton, NJ 07013-3928
Phone (973) 559-3760

Other practice location 2

230 Sherman Ave Ste A
Glen Ridge, NJ 07028-1520
Phone (973) 559-3760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190506000050 NJ Part B Supplier - Clinic/Group Practice 9032451406 Receives reassigned benefits from 5 practitioners
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

1 Orient Way
Ste F
Rutherford, NJ 07070

510 Hamburg Tpke
Ste 107
Wayne, NJ 07470
Phone (973) 559-3760

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1316411440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BOURBON ST",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HAMBURG TPKE STE 107",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702033",
            "telephone_number": "973-559-3760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 State Rt 3 Ste 5",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070133928",
            "country_code": "US",
            "telephone_number": "973-559-3760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 Sherman Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Glen Ridge",
            "state": "NJ",
            "postal_code": "070281520",
            "country_code": "US",
            "telephone_number": "973-559-3760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REHAB MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "DOSS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-559-3760",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.