Stacy L Paserchia, PT, MPT, TDPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01287700 Issued in NJ

Practice address

151 Summit Ave Ste 1
Summit, NJ 07901-2813

Phone

(732) 322-6858

NPI assigned

Sep 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Stacy L Potkulski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1346590379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CATON TER",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070064808",
            "telephone_number": "732-322-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SUMMIT AVE STE 1",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012813",
            "telephone_number": "732-322-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASERCHIA",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "PT, MPT, TDPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NJ",
            "license": "40QA01287700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01287700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "POTKULSKI",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Savan Parker, MD
• Pamela Rodman Paro, LCSW
• Taylor Parsons, DO
• Partners in Psychiatry, LLP
• Katherine A Paseka, M.ED.
• Amanda Meredith Pashelinsky
• Ami P Patel, CRNA
• Anjali Patel, D.O.
• Bhumika Patel, M.D.
• Jigar Patel, M.D.

• Physical Therapist in Summit, NJ
• Providers in Summit, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.