Individual provider Active NPI

Frank M Failla, DPT

  • Physical Therapist
  • Montclair, NJ
National Provider Identifier
1366635633
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01254100 Issued in NJ
Practice address
193 Bellevue Ave
Montclair, NJ 07043-1820
Phone
(973) 509-0827
NPI assigned
Aug 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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 40QA01254100 NJ Primary

Addresses

Primary practice location

193 Bellevue Ave
Montclair, NJ 07043-1820

Mailing address

552 Valley Rd
Montclair, NJ 07043-1805
Phone (973) 509-0827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071116000240 NJ Practitioner - Physical Therapist in Private Practice 6204924780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

388 Pompton Ave
Cedar Grove, NJ 07009-1814
Phone (917) 684-9789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01254100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Frank Failla Physical Therapy, LLC Physical Therapist CurrentSince May 1, 2013 Accepting new patients

Locations

388 Pompton Ave
Cedar Grove, NJ 07009
Phone (973) 228-0500

388 Pompton Ave
Ste 11
Cedar Grove, NJ 07009

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1366635633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431805",
            "telephone_number": "973-509-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 BELLEVUE AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431820",
            "telephone_number": "973-509-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILLA",
        "first_name": "FRANK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01254100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.