Phillip John Polentarutti, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01889300 Issued in NJ

Practice address

266 Harristown Rd
Glen Rock, NJ 07452-3302

Phone

(201) 445-7000

NPI assigned

Oct 9, 2019

Last updated

Feb 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pro Staff Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Nutley, NJ
  • NPI 1265750871

  Physical Therapist

  Medicare reassignment NPD
• Twin Boro Physical Therapy Associates PA

  dba Twin Boro Physical Therapy

  • Physical Therapist
  • Clark, NJ
  • NPI 1811937527
  Medicare reassignment NPD
• Twin Boro Physical Therapy Associates, PA

  dba Twin Boro Physical Therapy

  • Occupational Therapist
  • Newark, NJ
  • NPI 1659874857
  NPD
• St Josephs University Medical Center Inc.

  dba St. Joseph's University Medical Center Specialty Pharmacy

  • Community/Retail Pharmacy
  • Paterson, NJ
  • NPI 1477304541
  NPD (past)

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1376185546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523302",
            "telephone_number": "201-445-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523302",
            "telephone_number": "201-445-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLENTARUTTI",
        "first_name": "PHILLIP",
        "middle_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-09",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01889300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly C Pedicone, LCSW
• Amanda Rose Peraino, MA, ED.M
• Philip J. Aretsky, MD PA
• Playhouse Therapy PA
• Plus Acupuncture & Herbs LLC
• Tara Porfido, DPT
• Almerindo G. Portfolio Jr., M.D.
• Karllo Pozo, PT, DPT
• Glenn David Prettitore, MSPT
• Professional Occupational & Physical Therapy, PLLC

• Physical Therapist in Glen Rock, NJ
• Providers in Glen Rock, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.