Miguel Angel Mayorga, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01435700 Issued in NJ

Practice address

277 Prospect Ave
Hackensack, NJ 07601-2512

Phone

(201) 968-0303

Fax

(201) 968-0330

NPI assigned

Apr 30, 2012

Sex

Male

Sole proprietor

Yes

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ironbound Spine and Rehabilitation CenterGroup PAC ID 7517123920, 2 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.

• Ironbound Spine & Rehabilitation Center

  • Acupuncturist
  • Newark, NJ
  • NPI 1467710251
  Medicare reassignment Care Compare group NPD
• Back and Body Pain Relief LLC

  • Chiropractor
  • Springfield, NJ
  • NPI 1336656461
  Medicare reassignment NPD
• Premier Health Center, P.C.

  • Physical Therapist
  • Hackensack, NJ
  • NPI 1134170103
  Medicare reassignment NPD
• Prospect Medical PC

  • Internal Medicine Physician
  • Hackensack, NJ
  • NPI 1346365905
  NPD (past)

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352592000000",
    "number": "1538427331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012512",
            "telephone_number": "201-968-0303",
            "fax_number": "201-968-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012512",
            "telephone_number": "201-968-0303",
            "fax_number": "201-968-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYORGA",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01435700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maximilian Medical, LLC
• Maximum Health & Wellness Hackensack LLC
• Sherri Ann Mayans, APN
• Adam Seth Mayer, MD
• Janae Mayo, DPT
• Sharon Maza, M.D.
• Bracha Mazin, PA-C
• Annmarie Mazzeo, APNC
• Julia Mazzotta, FNP-C
• Juliana Mazzotta

• Physical Therapist in Hackensack, NJ
• Providers in Hackensack, 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 Nov 11, 2012; 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.