Organization Active NPI

Wasserman Orthopedic and Sports Rehab LLC

  • Orthopedic Physical Therapist
  • Englewood, NJ
National Provider Identifier
1326739152
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
WASSERMAN ORTHOPEDIC AND SPORTS REHAB LLC
Practice address
105 N Dean St
Englewood, NJ 07631-2813
Phone
(917) 544-4911
NPI assigned
May 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Noah Wasserman, DPT, CSCSNPI 1518142686
Title
Owner
Phone
(917) 544-4911

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
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

105 N Dean St
Englewood, NJ 07631-2813

Mailing address

330 Rutland Ave
Teaneck, NJ 07666-2841
Phone (917) 544-4911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230627003015 NJ Part B Supplier - Clinic/Group Practice 7810355534 Receives reassigned benefits from 4 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

105 N Dean St
Ste 5
Englewood, NJ 07631
Phone (201) 371-3271

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1326739152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 RUTLAND AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662841",
            "telephone_number": "917-544-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N DEAN ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312813",
            "telephone_number": "917-544-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASSERMAN ORTHOPEDIC AND SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "NOAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-544-4911",
        "authorized_official_credential": "DPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.