Active NPI
Elliott Luty, D.P.T.
- Physical Therapist
- River Edge, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01683800
- Practice address
- 530 Kinderkamack Rd
River Edge, NJ 07661-2140 - Phone
- (201) 523-9207
- Fax
- (201) 523-9208
- NPI assigned
- Sep 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01683800 | NJ | Primary |
Addresses
Primary practice location
530 Kinderkamack Rd
River Edge, NJ 07661-2140
Mailing address
2142 Utopia Pkwy
Whitestone, NY 11357-4142
Phone (718) 819-6805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Greenwood Ave
Montclair, NJ 07042-3649
Phone (973) 746-2424
3 Wing Dr
Suite 250
Cedar Knolls, NJ 07927-1018
Phone (862) 430-4099
301 S Livingston Ave
Suite 105
Livingston, NJ 07039-3929
Phone (862) 308-1144
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01683800 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
Locations
301 S Livingston Ave
Ste 105
Livingston, NJ 07039
Phone (862) 308-1144
1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424
530 Kinderkamack Rd
River Edge, NJ 07661
Phone (201) 523-9207
84 Orient Way
Rutherford, NJ 07070
Phone (201) 514-4900
524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591
68 River Rd
Summit, NJ 07901
Phone (908) 277-0800
576 Broadhollow Rd
Melville, NY 11747
2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610
Organizations & group practices 3
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.
-
- Occupational Therapist
- Sicklerville, NJ
- NPI 1215487772
Physical Therapist
-
- Occupational Therapist
- Randolph, NJ
- NPI 1104376680
Physical Therapist
-
- Occupational Therapist
- Englewood, NJ
- NPI 1922558402
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1407303647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2142 UTOPIA PKWY",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113574142",
"telephone_number": "718-819-6805",
"fax_number": "347-841-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 KINDERKAMACK RD",
"city": "RIVER EDGE",
"state": "NJ",
"postal_code": "076612140",
"telephone_number": "201-523-9207",
"fax_number": "201-523-9208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTY",
"first_name": "ELLIOTT",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-06",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01683800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in River Edge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.