Professional Orthopedic and Sports Physical Therapy of NJ, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC

Practice address

440 Old Hook Rd
Emerson, NJ 07630-2302

Phone

(201) 497-6752

Fax

(201) 497-6756

NPI assigned

Jul 28, 2014

Last updated

Mar 28, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.As reported in NPPES

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

Authorized official

Name

Ms. Kathleen Brush

Title

Credentialing Manager

Phone

(718) 819-6805

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Professional Orthopedic Sports PT

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Professional Orthopedic and Sports Physical Therapy, P.C.

  • Physical Therapist
  • Montville, NJ
  • NPI 1700387966
  NPPES parent name

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1376951889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "516-321-2400",
            "fax_number": "516-321-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 OLD HOOK RD",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076302302",
            "telephone_number": "201-497-6752",
            "fax_number": "201-497-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY OF NJ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.",
        "enumeration_date": "2014-07-28",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "BRUSH",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "718-819-6805",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "255015",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert H Pittman, MD
• Premier Medical Alliance LLC
• Brittany Anne Prisco, MS CCC-SLP
• Proactive Foot and Ankle
• Professional Occupational & Physical Therapy, PLLC
• Professional Sports Medicine Associates
• Pt2U
• Pulmonary & Medical Associates of Pascack Valley
• Felicia M Raju
• Jennifer Randall, MD

• Physical Therapist in Emerson, NJ
• Providers in Emerson, 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 Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.