Individual provider Active NPI

Athena Dianne Niemczak

  • Physical Therapist
  • Stratford, NJ
National Provider Identifier
1497734511
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01186700 Issued in NJ
Practice address
42 E Laurel Rd
Nova Care - University Doctors Pavilion, Ste1600
Stratford, NJ 08084
Phone
(856) 566-1311
Fax
(856) 566-1331
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 40QA01186700 NJ Primary

Addresses

Primary practice location

42 E Laurel Rd
Nova Care - University Doctors Pavilion, Ste1600
Stratford, NJ 08084

Mailing address

1764 Hillside Dr
Cherry Hill, NJ 08003-3708
Phone (856) 383-8956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000575 NJ Practitioner - Physical Therapist in Private Practice 2466635701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rothman Orthopaedics of New Jersey, LLCGroup PAC ID 6709864846, 175 clinicians

Practice addresses (Care Compare)

999 Route 73 N
Suite 401
Marlton, NJ 08053-1227
Phone (800) 321-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01186700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Dec 26, 2010 Accepting new patients
Rehabclinics SPT Inc CurrentSince Mar 20, 2020 Accepting new patients
Rehabclinics SPT Inc. Current Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Mar 20, 2020 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Dec 26, 2010 Accepting new patients

Locations

2144 US Highway 130
Ste 12
Bordentown, NJ 08505
Phone (609) 324-9320

2500 English Creek Ave
Ste 1300
Egg Hbr Twp, NJ 08234
Phone (609) 677-6060

999 Route 73 N
Ste 401
Marlton, NJ 08053

999 Route 73 N
Marlton, NJ 08053
Phone (856) 424-2929

127 Bridgeton Pike
Unit D
Mullica Hill, NJ 08062
Phone (856) 478-0275

42 E Laurel Rd
Ste 1600
Stratford, NJ 08084
Phone (856) 435-6332

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Organizations & group practices 5

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497734511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 HILLSIDE DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033708",
            "telephone_number": "856-383-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD",
            "address_2": "NOVA CARE - UNIVERSITY DOCTORS PAVILION, STE1600",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "08084",
            "telephone_number": "856-566-1311",
            "fax_number": "856-566-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMCZAK",
        "first_name": "ATHENA",
        "middle_name": "DIANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01186700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.