1 Prospect Physical Therapy, LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

40QA01351300 Issued in NJ

Legal business name

1 PROSPECT PHYSICAL THERAPY, LLC

Practice address

470 Prospect Ave
Suite 100
West Orange, NJ 07052-4153

Phone

(973) 731-7877

Fax

(973) 731-6332

NPI assigned

Jul 13, 2009

Organization subpart

No

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

Authorized official

Name

Elan Araten, PTNPI 1801113246

Title

Owner/Member

Phone

(973) 731-7877

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elan Araten, DPT

  • Physical Therapist
  • West Orange, NJ
  • NPI 1801113246
  Medicare reassignment Care Compare group NPD Authorized official
• Justin Trilling, D.P.T.

  • Specialist
  • West Orange, NJ
  • NPI 1265760573
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1356570246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 PROSPECT AVE",
            "address_2": "SUITE 100",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524153",
            "telephone_number": "973-731-7877",
            "fax_number": "973-731-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 PROSPECT AVE",
            "address_2": "SUITE 100",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524153",
            "telephone_number": "973-731-7877",
            "fax_number": "973-731-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1 PROSPECT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "ARATEN",
        "authorized_official_first_name": "ELAN",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "973-731-7877",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01351300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 20 Summit Street Operations LLC (Summit Ridge Center)
• 828 Express LLC
• Jason Ailbruz Abaza, DC
• Abbas a. Shehadeh MD, PA
• Abbassi and Agrama P C

• Orthopedic Physical Therapist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.