Myranda Nadine Oettel, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02121200 Issued in NJ

Practice address

740 Marne Hwy Ste 203
Moorestown, NJ 08057-3127

Phone

(856) 914-1400

Fax

(856) 914-1444

NPI assigned

Sep 1, 2022

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NY2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icahn School of Medicine at Mount Sinai

  dba Rehabilitation Medicine Associates Department of Mount Sinai.

  • Rehabilitation Practitioner
  • New York, NY
  • NPI 1386980985
  Medicare reassignment Care Compare group NPD
• One Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Bryn Mawr, PA
  • NPI 1679804413
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Strive Physical Therapy Specialists LLC

  • Physical Therapy Clinic/Center
  • Philadelphia, PA
  • NPI 1659962587

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1447970025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MARNE HWY STE 203",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573127",
            "telephone_number": "856-914-1400",
            "fax_number": "856-914-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OETTEL",
        "first_name": "MYRANDA",
        "middle_name": "NADINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02121200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen O'Brien
• Kevin Paul O'Donnell, M.D.
• Mikhail Oakes, LSW
• Occupational Training Center of Burlington County Inc. (OTC Services)
• Fausat Funmilola Odubiyi, NURSE PRACTITIONER
• Elisabeth Offenberger, MS,RD,LDN,CDCES
• Oluremi Olabinjo
• Oliver Chiropractic Assoc P.a.
• Alexandra Oliver, APN-C
• Thomas D Oliver, D.C.

• Physical Therapist in Moorestown, NJ
• Providers in Moorestown, 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 Sep 1, 2022; 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.