Active NPI
East Coast Rehabilitation Services LLC
- Physical Therapy Clinic/Center
- Kenilworth, NJ
National Provider Identifier
1417228917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 40QA01110500
- Legal business name
- EAST COAST REHABILITATION SERVICES LLC
- Practice address
- 700 Fairfield Ave
Kenilworth, NJ 07033-2012 - Phone
- (908) 241-8591
- Fax
- (855) 631-4348
- NPI assigned
- Jan 16, 2012
- Organization subpart
- No
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Kenilworth, NJ
- NPI 1003955881
-
- Psychiatry Physician
- New York, NY
- NPI 1396143806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140310000357 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 9931333705 |
Receives reassigned benefits from 8 practitioners Practice locations: Kenilworth, NJ; Union, NJ |
National Provider Directory
National Provider DirectoryLocations
700 Fairfield Ave
Kenilworth, NJ 07033
Phone (908) 241-8591
552 Boulevard
Kenilworth, NJ 07033
Phone (908) 276-9060
2333 Morris Ave
Ste B208A
Union, NJ 07083
Phone (908) 361-7813
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maria Nisperos, PT
- Title
- Co-Owner
- Phone
- (973) 704-7734
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 40QA01110500 | NJ | Primary |
Addresses
Primary practice location
700 Fairfield Ave
Kenilworth, NJ 07033-2012
Mailing address
700 Fairfield Ave
Kenilworth, NJ 07033-2012
Phone (908) 241-8591
NPI Registry JSON
{
"created_epoch": "1326672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1369958400000",
"number": "1417228917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 FAIRFIELD AVE",
"city": "KENILWORTH",
"state": "NJ",
"postal_code": "070332012",
"telephone_number": "908-241-8591",
"fax_number": "855-631-4348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 FAIRFIELD AVE",
"city": "KENILWORTH",
"state": "NJ",
"postal_code": "070332012",
"telephone_number": "908-241-8591",
"fax_number": "855-631-4348"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST COAST REHABILITATION SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-01-16",
"last_updated": "2013-05-31",
"status": "A",
"authorized_official_last_name": "NISPEROS",
"authorized_official_first_name": "MARIA",
"authorized_official_title_or_position": "CO-OWNER",
"authorized_official_telephone_number": "973-704-7734",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "NJ",
"license": "40QA01110500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenilworth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.