Individual provider Active NPI

Christopher J Lang, DPT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1548581879
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026796 Issued in NY
Practice address
375 Seguine Ave
Staten Island, NY 10309-3932
Phone
(718) 226-2724
Fax
(718) 226-3925
NPI assigned
Jun 22, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01308700 NJ
Physical Therapist 225100000X 026796 NY Primary

Addresses

Primary practice location

375 Seguine Ave
Staten Island, NY 10309-3932

Mailing address

22 Farm Tree Rd
Manalapan, NJ 07726-3756
Phone (646) 763-2875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191121000118 NJ Practitioner - Physical Therapist in Private Practice 7012349533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physical Therapy, LLCGroup PAC ID 2466872742, 2 clinicians

Practice addresses (Care Compare)

680 Route 33 E
Unit 14
East Windsor, NJ 08520-5806
Phone (877) 752-9637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01308700NJMDPhysical Therapist
026796NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physical Therapy, LLC Physical Therapist CurrentSince Oct 16, 2020 Accepting new patients
Coastal Home Rehabilitation, LLC Physical Therapist CurrentSince Dec 19, 2019 Accepting new patients
Ultima Rehab-NJ LLC Past Accepting new patients

Locations

680 State Route 33
Unit 14
East Windsor, NJ 08520
Phone (877) 752-9637

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1548581879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 FARM TREE RD",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263756",
            "telephone_number": "646-763-2875",
            "fax_number": "718-226-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SEGUINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093932",
            "telephone_number": "718-226-2724",
            "fax_number": "718-226-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01308700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.