Elysha Bembury

Individual provider Active NPI Physical Therapist · Clark, NJ

NPI 1346907599 · NPPES record last updated Nov 23, 2021

Key facts

NPI
1346907599
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
40QA02059900 (NJ)
Practice address
60 Walnut Ave Ste 180
Clark, NJ 07066-1647
Phone
(732) 340-1012
NPI assigned
Nov 23, 2021
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Procare Rehabilitation, LLC (69 clinicians)

Practice addresses (Care Compare)

60 Walnut Ave
Suite 180
Clark, NJ 07066-1647
Phone (732) 340-1012

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20211222002082 NJ Practitioner - Physical Therapist in Private Practice 8022409291 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
40QA02059900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synaptic Rehabilitation, LLC Physical Therapist Current
since Jul 18, 2022
Accepting new patients
Procare Rehabilitation, LLC Physical Therapist Current
since Nov 29, 2021
Accepting new patients
Synaptic Rehab Bridgewater Physical Therapist Past
since Jul 18, 2022
Accepting new patients

Locations

60 Walnut Ave
Ste 180
Clark, NJ 07066
Phone (732) 340-1012

4 Walter E Foran Blvd
Flemington, NJ 08822
Phone 9082370000 ext. 90823

4 Walter E Foran Blvd
Ste 203
Flemington, NJ 08822
Phone (732) 340-1012

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02059900 NJ Yes

Addresses

Primary practice location

60 Walnut Ave Ste 180
Clark, NJ 07066-1647

Mailing address

4 Walter E Foran Blvd Ste 203
Flemington, NJ 08822-4666
Phone (908) 237-0000

Other providers in Clark, NJ

All providers in Clark, NJ · Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.