Active NPI
Marc David Delellis, DPT
- Physical Therapist
- Clark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01925000
- Practice address
- 1180 Raritan Rd
Clark, NJ 07066-1311 - Phone
- (908) 276-2626
- Fax
- (908) 276-8260
- NPI assigned
- Jul 27, 2020
- Sex
- Male
- 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 | 40QA01925000 | NJ | Primary |
Addresses
Primary practice location
1180 Raritan Rd
Clark, NJ 07066-1311
Mailing address
PO Box 1014
Clark, NJ 07066-1014
Phone (732) 855-9751
Other practice location 1
200 Tuckerton Rd Ste 17
Medford, NJ 08055-8806
Phone (856) 396-2250
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
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
390 State Route 10
Suite 202
Randolph, NJ 07869-2141
Phone (973) 895-9925
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
70 Ridge Rd
Lyndhurst, NJ 07071
Phone (201) 933-4775
1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424
390 State Route 10
Ste 202
Randolph, NJ 07869
Phone (973) 895-9925
524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591
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": "1595808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631232000000",
"number": "1346859394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1014",
"city": "CLARK",
"state": "NJ",
"postal_code": "070661014",
"telephone_number": "732-855-9751",
"fax_number": "732-855-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 RARITAN RD",
"city": "CLARK",
"state": "NJ",
"postal_code": "070661311",
"telephone_number": "908-276-2626",
"fax_number": "908-276-8260"
}
],
"practiceLocations": [
{
"address_1": "200 Tuckerton Rd Ste 17",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "NJ",
"postal_code": "080558806",
"country_code": "US",
"telephone_number": "856-396-2250",
"fax_number": "856-810-0373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DELELLIS",
"first_name": "MARC",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-27",
"last_updated": "2021-09-10",
"certification_date": "2021-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01925000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.