Individual provider Active NPI

Maria May Lagman Dizon, PT

  • Geriatric Physical Therapist
  • Voorhees, NJ
National Provider Identifier
1538545405
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
40QA01122800 Issued in NJ
Practice address
306 W Somerdale Rd
Voorhees, NJ 08043-2237
Phone
(856) 504-3150
Fax
(856) 504-3157
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 40QA01122800 NJ Primary

Addresses

Primary practice location

306 W Somerdale Rd
Voorhees, NJ 08043-2237

Mailing address

306 W Somerdale Rd
Voorhees, NJ 08043-2237
Phone (856) 504-3150

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529001112 NJ Practitioner - Physical Therapist in Private Practice 7810339439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01122800NJMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Geriatrics CurrentSince Apr 22, 2024 Accepting new patients
Functional Independence Therapy Rehabilitation Inc Past Accepting new patients

Locations

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

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

Organizations & group practices 2

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1538545405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W SOMERDALE RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432237",
            "telephone_number": "856-504-3150",
            "fax_number": "856-504-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W SOMERDALE RD",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432237",
            "telephone_number": "856-504-3150",
            "fax_number": "856-504-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "MARIA MAY",
        "middle_name": "LAGMAN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NJ",
            "license": "40QA01122800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.