Magna Vita Rehab and Wellness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MAGNA VITA REHAB AND WELLNESS

Doing business as

Magna Vita Rehab and Wellness LLC

Practice address

61 Davis Ave
Bloomfield, NJ 07003-4116

Phone

(973) 566-4772

NPI assigned

Dec 15, 2022

Last updated

Jan 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roslyn Mandrique Batiancila, DPTNPI 1801108527

Title

Managing Director

Phone

(973) 566-4772

Specialties & licenses 1

Addresses

Other names 1

• Magna Vita Rehab and Wellness LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roslyn M Batiancila, PT, DPT

  • Physical Therapist
  • Fair Lawn, NJ
  • NPI 1801108527
  Medicare reassignment Care Compare group NPD Authorized official
• Dante Velasquez Henson, OTR/L

  • Occupational Therapist
  • Union, NJ
  • NPI 1619902145
  Medicare reassignment Care Compare group NPD
• Daryll Adrian Ang Henson, OTD, OTR/L

  • Occupational Therapist
  • Union, NJ
  • NPI 1235851213
  NPD
• Ellen J Gross, LCSW

  • Clinical Social Worker
  • Randolph, NJ
  • NPI 1144381161
  NPD (past)

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1518679190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DAVIS AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034116",
            "telephone_number": "973-566-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DAVIS AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034116",
            "telephone_number": "973-566-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNA VITA REHAB AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "BATIANCILA",
        "authorized_official_first_name": "ROSLYN",
        "authorized_official_middle_name": "MANDRIQUE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "973-566-4772",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@magnavitarehab.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "61 Davis Ave",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070034116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Magna Vita Rehab and Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magna Vita Rehab and Wellness LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Bloomfield, NJ
• Providers in Bloomfield, 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 Jan 25, 2023; 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.

Verify at the official NPI Registry.