Individual provider Active NPI

Michelle Tawil, DPT

  • Rehabilitation Practitioner
  • Englewood, NJ
National Provider Identifier
1497824163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
QA009855 Issued in NJ
Practice address
500 Grand Ave
1
Englewood, NJ 07631-4967
Phone
(201) 567-2277
Fax
(201) 567-7506
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X QA009855 NJ Primary

Addresses

Primary practice location

500 Grand Ave
1
Englewood, NJ 07631-4967

Mailing address

500 Grand Ave
1
Englewood, NJ 07631-4967
Phone (201) 567-2277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000433 NJ Practitioner - Physical Therapist in Private Practice 4587621099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tawil Physical Therapy and Sports Performance PAGroup PAC ID 9032361092, 2 clinicians

Practice addresses (Care Compare)

8701 Kennedy Blvd
North Bergen, NJ 07047-4387
Phone (201) 552-9072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA009855NJMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tawil Physical Therapy and Sports Performance, PA CurrentSince Nov 21, 2012 Accepting new patients
Columbia Doctors of New Jersey, P. C. Past Accepting new patients
Sportscare Institute, Inc. Past Accepting new patients
Physical Medicine and Rehabilitation Center PA Rehabilitation Practitioner Past Accepting new patients
Sportscare of America, PC PastSince Feb 2, 2011 Accepting new patients

Locations

8701 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 552-9072

8701 Kennedy Blvd
#F
North Bergen, NJ 07047

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497824163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE",
            "address_2": "1",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314967",
            "telephone_number": "201-567-2277",
            "fax_number": "201-567-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE",
            "address_2": "1",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314967",
            "telephone_number": "201-567-2277",
            "fax_number": "201-567-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWIL",
        "first_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NJ",
            "license": "QA009855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.