Kevin Pineda, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

40QA02057300 Issued in NJ

Practice address

24-17 Fair Lawn Ave
Fair Lawn, NJ 07410-3429

Phone

(201) 794-4417

Fax

(201) 794-4419

NPI assigned

Nov 10, 2021

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

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Natty Bandasak Physio PerformanceGroup PAC ID 4284025131, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Natty Bandasak Physio Performance

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1770072142
  Medicare reassignment Care Compare group NPD
• Pro Staff Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Nutley, NJ
  • NPI 1265750871
  Medicare reassignment NPD
• Twin Boro Physical Therapy Associates PA

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

  • Occupational Therapist
  • Newark, NJ
  • NPI 1659874857
  NPD
• Pro Staff Institute, LLC

  • Rehabilitation Clinic/Center
  • Nutley, NJ
  • NPI 1609280718
  NPD (past)

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1386300697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661014",
            "telephone_number": "732-855-9751",
            "fax_number": "732-855-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24-17 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103429",
            "telephone_number": "201-794-4417",
            "fax_number": "201-794-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "KEVIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "40QA02057300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Petrolia
• Marilyn Sandra Pettinati, LCSW
• Valerie Pheanis, LCSW, MT-BC, CHN
• Pillar of Light, Inc
• Pine Group LLC
• Keith M Pinelli, DC
• Thomas L Pinelli, DC
• Lisa Marie Pinkston, MSOTR
• Michele Lynn Pisacane, RPH
• Bryan Scott Piskadlo, RPH

• Physical Medicine & Rehabilitation Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.