NPIMap

Organization Active NPI

Activecare Physical Therapy LLC

  • Physical Therapist
  • Dover, NJ
National Provider Identifier
1407898778
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVECARE PHYSICAL THERAPY LLC
Practice address
600 Mount Pleasant Ave
Suite F
Dover, NJ 07801-1629
Phone
(973) 366-4000
Fax
(973) 366-4998
NPI assigned
Jun 12, 2006
Last updated
Jan 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Mr. Rik Couwenberg, PTNPI 1578552345
Title
Owner/Managing Directot/PT
Phone
(973) 366-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

600 Mount Pleasant Ave
Suite F
Dover, NJ 07801-1629

Mailing address

600 Mount Pleasant Ave
Suite F
Dover, NJ 07801-1629
Phone (973) 366-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000388 NJ Part B Supplier - Clinic/Group Practice 4082501572 Receives reassigned benefits from 12 practitioners
Practice locations: Denville, NJ; Dover, NJ; Ledgewood, NJ

National Provider Directory

National Provider Directory

Locations

35 W Main St
Ste 202
Denville, NJ 07834
Phone (973) 625-7800

41 Pine St
Ste 102
Rockaway, NJ 07866
Phone (973) 983-6600

27 Sunset Strip
Succasunna, NJ 07876
Phone (973) 598-9110

66 Towne Ctr
Ste 204
Succasunna, NJ 07876
Phone (973) 598-9111

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1407898778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MOUNT PLEASANT AVE",
            "address_2": "SUITE F",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078011629",
            "telephone_number": "973-366-4000",
            "fax_number": "973-366-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MOUNT PLEASANT AVE",
            "address_2": "SUITE F",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078011629",
            "telephone_number": "973-366-4000",
            "fax_number": "973-366-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVECARE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "COUWENBERG",
        "authorized_official_first_name": "RIK",
        "authorized_official_title_or_position": "OWNER/MANAGING DIRECTOT/PT",
        "authorized_official_telephone_number": "973-366-4000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.