Taylor Michelle Wittstock, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02191300 Issued in NJ

Practice address

115 N Route 73 Unit 80
West Berlin, NJ 08091-9202

Phone

(856) 335-4938

NPI assigned

Aug 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipta Clinical, LLCGroup PAC ID 0749456119, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ipta Clinical, LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
  • NPI 1760764484

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• 3 Dimensional Physical Therapy - Pelvic Health LLC

  • Physical Therapist
  • Medford, NJ
  • NPI 1275348500
  NPD

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1508649807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70 STE 19",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N ROUTE 73 UNIT 80",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "080919202",
            "telephone_number": "856-335-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTSTOCK",
        "first_name": "TAYLOR",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02191300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Devereux Foundation
• Thrift Drug Inc
• Tidal Physical Therapy & Performance
• Wal-Mart Stores East LP
• Kerry White, RD
• Suzanne Young

• Physical Therapist in West Berlin, NJ
• Providers in West Berlin, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.