Individual provider Active NPI

Alyssa Diaz, DPT

  • Physical Therapist
  • Aberdeen, NJ
National Provider Identifier
1366025900
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01944200 Issued in NJ
Practice address
557 S Atlantic Ave
Aberdeen, NJ 07747-2258
Phone
(732) 997-4988
NPI assigned
May 2, 2021
Last updated
May 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01944200 NJ Primary

Addresses

Primary practice location

557 S Atlantic Ave
Aberdeen, NJ 07747-2258

Mailing address

18 Bennington Rd
Bordentown, NJ 08505-2504
Phone (609) 310-0229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220921002260 NJ Practitioner - Physical Therapist in Private Practice 1153706536 Reassigns benefits to 2 organizations

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
Paragon Sport Spine and Wellness LLCGroup PAC ID 1153658299, 11 clinicians

Practice addresses (Care Compare)

17 Main St
Suite 403
Robbinsville, NJ 08691-1436
Phone (609) 686-2050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Sport Spine & Wellness LLC Physical Therapist CurrentSince Apr 28, 2023 Accepting new patients
Northeast Surgery Associates LLC CurrentSince Sep 7, 2022 Accepting new patients
Spine & Sports Medicine of Lincroft, LLC Physical Therapist CurrentSince Sep 7, 2022 Accepting new patients
Paragon Health Chiropractic CurrentSince Apr 28, 2023 Accepting new patients

Locations

5 Swimming River Rd
Lincroft, NJ 07738
Phone (732) 451-4578

17 Main St
Ste 403
Robbinsville, NJ 08691
Phone (609) 686-2050

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1366025900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BENNINGTON RD",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052504",
            "telephone_number": "609-310-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 S ATLANTIC AVE",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077472258",
            "telephone_number": "732-997-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ALYSSA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01944200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.

Verify at the official NPI Registry.