Platinum Physiatry

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PLATINUM PHYSIATRY

Practice address

75 Dudley Dr
Bergenfield, NJ 07621-2613

Phone

(718) 362-8182

Fax

(718) 414-1651

NPI assigned

Apr 1, 2022

Organization subpart

No

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

Authorized official

Name

Susanna ShepperNPI 1164792420

Title

Owner

Phone

(732) 361-2859

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Susanna Shepper, MD

  • Physical Medicine & Rehabilitation Physician
  • New City, NY
  • NPI 1164792420

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1346980737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 DUDLEY DR",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212613",
            "telephone_number": "718-362-8182",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 DUDLEY DR",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212613",
            "telephone_number": "718-362-8182",
            "fax_number": "718-414-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM PHYSIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-01",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "SHEPPER",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-361-2859"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lady J Perez, LCSW
• Melissa Peterson, APN
• Rachell Peterson
• Pinnacle Homecare Rehabilitation LLC
• Tiffany Lee Pizarro, LPN
• PMR Medical PC
• Wayne M Poller, DC
• Desiree Polonia, LMHC
• Karen Ponce
• Post at Home LLC

• Clinic/Center in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.