Individual provider Active NPI

Daniel Adam Roig, DPT

  • Physical Therapist
  • South Orange, NJ
National Provider Identifier
1508193079
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01335000 Issued in NJ
Practice address
177 Valley St
South Orange, NJ 07079-2836
Phone
(973) 761-0077
Fax
(973) 761-0024
NPI assigned
Nov 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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 40QA01335000 NJ Primary

Addresses

Primary practice location

177 Valley St
South Orange, NJ 07079-2836

Mailing address

177 Valley St
South Orange, NJ 07079-2836
Phone (973) 761-0077

Other identifiers 1

IdentifierTypeStateIssuer
40QA01335000OtherNJNEW JERSEY STATE PHYSICAL THERAPIST LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101124001080 NJ Practitioner - Physical Therapist in Private Practice 2163618588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

855 Valley Rd
Suite 202
Clifton, NJ 07013-6402
Phone (973) 852-3120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01335000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Orange Chiropractic Center CurrentSince Jan 15, 2016 Accepting new patients
Sportsmed PT LLC Physical Therapist CurrentSince Feb 17, 2025 Accepting new patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Feb 10, 2024 Accepting new patients

Locations

855 Valley Rd
Ste 202
Clifton, NJ 07013
Phone (973) 601-5947

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

177 Valley St
South Orange, NJ 07079
Phone (862) 206-4072

Organizations & group practices 3

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": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1508193079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 VALLEY ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792836",
            "telephone_number": "973-761-0077",
            "fax_number": "973-761-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 VALLEY ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792836",
            "telephone_number": "973-761-0077",
            "fax_number": "973-761-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROIG",
        "first_name": "DANIEL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-04",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01335000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY STATE PHYSICAL THERAPIST LICENSE",
            "identifier": "40QA01335000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.