Jason M Lydell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01752500 Issued in NJ

Practice address

6701 Bergenline Ave
West New York, NJ 07093-1704

Phone

(201) 758-9100

NPI assigned

Sep 8, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Rehab, LLCGroup PAC ID 3173428562, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.01 of 100Reported as group

Quality

100

Improvement activities

40

Cost

40.03

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 and National Provider Directory roles.

• Community Rehab LLC

  • Physical Therapist
  • South Sioux City, NE
  • NPI 1932218773
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1396263497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931704",
            "telephone_number": "201-758-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDELL",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-08",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01752500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LISCENSE",
            "identifier": "40QA01752500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis Goyco MD, PC
• Loving Care Agency, Inc.
• Jenny Patricia Lozano-Rivera, LCSW
• Bea Sheridan Lucas, MD
• Jane Angela Lukaszczyk, COTA
• M & M Pharmacy Corp
• Mach Art Academy
• Eidy D Macias-Perez
• Melanie Macintosh, PMHNP
• Daniel W Maenner, D.O.

• Physical Therapist in West New York, NJ
• Providers in West New York, 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 Jun 13, 2024; 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.