Individual provider Active NPI

Crisel Panes- Lattao

  • Physical Therapist
  • Williamstown, NJ
National Provider Identifier
1497047005
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20386 Issued in PA
Practice address
332 Comfort Rd
Williamstown, NJ 08094-2977
Phone
(484) 535-0508
NPI assigned
May 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20386 PA Primary

Addresses

Primary practice location

332 Comfort Rd
Williamstown, NJ 08094-2977

Mailing address

332 Comfort Rd
Williamstown, NJ 08094-2977
Phone (484) 535-0508

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231129002524 NJ Practitioner - Physical Therapist in Private Practice 6901254044 Reassigns benefits to 2 organizations

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
Lakas Rehabilitation ServicesGroup PAC ID 5294260485, 2 clinicians

Practice addresses (Care Compare)

64 Trent Rd
Turnersville, NJ 08012-1821
Phone (856) 246-0436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20386PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Max Potential Rehab Physical Therapist CurrentSince Oct 21, 2023 Accepting new patients
Lakas Rehabilitation Services Physical Therapist CurrentSince Sep 16, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1305417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1497047005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 COMFORT RD",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080942977",
            "telephone_number": "484-535-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 COMFORT RD",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080942977",
            "telephone_number": "484-535-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANES- LATTAO",
        "first_name": "CRISEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-15",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "20386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.