Innocent Urayai Rwakonda, PHYSICAL THERAPIST
Individual provider Active NPI Physical Therapist · Montague, NJ
NPI 1386790467 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386790467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT010414L (PA)
- Practice address
- 218A Shore Drive
Montague, NJ 07827-0263 - Phone
- (973) 293-8351
- Fax
- (973) 293-8351
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Physical Therapy and Wellness Inc
Practice addresses (Care Compare)
518 Route 6 and 209
Milford, PA 18337-9424
Phone (570) 296-3333
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111026000215 | PA | Practitioner - Physical Therapist in Private Practice | 7810160579 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Physical Therapy & Wellness Inc | Physical Therapist | Current |
Accepting new patients |
Locations
16 Maybrook Rd
Ste G
Campbell Hall, NY 10916
1040 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 821-9135
2380 Schoenersville Rd
Bethlehem, PA 18017
Phone (484) 215-4690
102 Dingman Pl
Dingmans Ferry, PA 18328
Phone (570) 253-8906
116 Atlantic Ave
Ste B
Dingmans Ferry, PA 18328
Phone (570) 828-0000
232 Sunrise Ave
Honesdale, PA 18431
Phone (570) 251-8003
518 Route 6 and 209
Milford, PA 18337
Phone (570) 296-3333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT010414L | PA | Yes |
Addresses
Primary practice location
218A Shore Drive
Montague, NJ 07827-0263
Mailing address
PO Box 1263
Montague, NJ 07827-0263
Phone (973) 293-8351
Other providers in Montague, NJ
- Rha Health Services NJ LLC
- Rha Health Services NJ LLC
- Nilda Margarita Rivera
- Shekera Robinson
- Sarah E Rome
- Shoprite Supermarkets, Inc
- Sussex County Pediatric Associates
- Yiou Wang
- Eric Williams
- Willowglen Academy - New Jersey. Inc.
All providers in Montague, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.