Individual provider Active NPI

Chibuike Obinnakwelu, DPT

  • Physical Therapist
  • Matawan, NJ
National Provider Identifier
1538993274
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02275200 Issued in NJ
Practice address
144 State Route 34
Matawan, NJ 07747-2132
Phone
(732) 320-6285
Fax
(732) 374-9864
NPI assigned
Aug 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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 40QA02275200 NJ Primary

Addresses

Primary practice location

144 State Route 34
Matawan, NJ 07747-2132

Mailing address

144 State Route 34
Matawan, NJ 07747-2132
Phone (732) 320-6285

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916001539 NJ Practitioner - Physical Therapist in Private Practice 2163963398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old Bridge Spine and Wellness Center,PAGroup PAC ID 7416137492, 23 clinicians
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

144 Hwy 34
Matawan, NJ 07747-2132
Phone (732) 320-6285

218 Bloomfield Ave
Bloomfield, NJ 07003-5741
Phone (973) 750-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02275200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Physical Therapist CurrentSince Sep 16, 2025 Accepting new patients
Old Bridge Spine & Wellness Center,PA Physical Therapist CurrentSince Aug 27, 2024 Accepting new patients

Locations

218 Bloomfield Ave
Bloomfield, NJ 07003
Phone (973) 750-0880

218 Bloomfield Ave
Bloomfield, NJ 07003

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

144 State Route 34
Matawan, NJ 07747
Phone (732) 316-5895

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": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1538993274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STATE ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-320-6285",
            "fax_number": "732-374-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STATE ROUTE 34",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472132",
            "telephone_number": "732-320-6285",
            "fax_number": "732-374-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBINNAKWELU",
        "first_name": "CHIBUIKE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02275200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.