Active NPI
Edgewater Physical Therapy Group
- Physical Therapist
- Edgewater, NJ
National Provider Identifier
1497515779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- EDGEWATER PHYSICAL THERAPY GROUP
- Practice address
- 19 The Promenade SPC A3B
Edgewater, NJ 07020-2126 - Phone
- (201) 377-1510
- NPI assigned
- Mar 21, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony Emadzadeh
- Title
- Owner - Physical Therapist
- Phone
- (201) 519-2958
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
19 The Promenade SPC A3B
Edgewater, NJ 07020-2126
Mailing address
19 The Promenade SPC A3B
Edgewater, NJ 07020-2126
Phone (201) 377-1510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240606001111 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5991247942 |
Receives reassigned benefits from 3 practitioners Practice locations: Edgewater, NJ |
National Provider Directory
National Provider DirectoryLocations
19 The Promenade
Spc A3B
Edgewater, NJ 07020
Phone (201) 377-1510
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- West New York, NJ
- NPI 1598995532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753315200000",
"number": "1497515779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 THE PROMENADE SPC A3B",
"city": "EDGEWATER",
"state": "NJ",
"postal_code": "070202126",
"telephone_number": "201-377-1510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 THE PROMENADE SPC A3B",
"city": "EDGEWATER",
"state": "NJ",
"postal_code": "070202126",
"telephone_number": "201-377-1510"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDGEWATER PHYSICAL THERAPY GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-21",
"last_updated": "2025-07-24",
"certification_date": "2025-07-24",
"status": "A",
"authorized_official_last_name": "EMADZADEH",
"authorized_official_first_name": "TONY",
"authorized_official_title_or_position": "OWNER - PHYSICAL THERAPIST",
"authorized_official_telephone_number": "201-519-2958"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edgewater, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.