Organization Active NPI

Paramount Rehabilitation LLC

  • Physical Medicine & Rehabilitation Physician
  • Fair Lawn, NJ
National Provider Identifier
1548634652
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
40QA01528100 Issued in NJ
Legal business name
PARAMOUNT REHABILITATION LLC
Practice address
16-00 Route 208 South
Suite 204
Fair Lawn, NJ 07410-2503
Phone
(201) 880-6207
Fax
(201) 880-6208
NPI assigned
Nov 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

Name
Dr. Eugene Gordon, PT, DPT
Title
Physical Therapist/Owner
Phone
(201) 880-6207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 40QA01528100 NJ Primary

Addresses

Primary practice location

16-00 Route 208 South
Suite 204
Fair Lawn, NJ 07410-2503

Mailing address

16-00 Route 208 South
Suite 204
Fair Lawn, NJ 07410-2503
Phone (201) 880-6207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160608000284 NJ Part B Supplier - Clinic/Group Practice 5890085518 Receives reassigned benefits from 2 practitioners
Practice locations: Fair Lawn, NJ

National Provider Directory

National Provider Directory

Locations

16-00 Route 208
Ste 204
Fair Lawn, NJ 07410
Phone (201) 880-6207

350 W Passaic St
Ste 2
Rochelle Park, NJ 07662
Phone (201) 880-6207

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1548634652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-00 ROUTE 208 SOUTH",
            "address_2": "SUITE 204",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102503",
            "telephone_number": "201-880-6207",
            "fax_number": "201-880-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-00 ROUTE 208 SOUTH",
            "address_2": "SUITE 204",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102503",
            "telephone_number": "201-880-6207",
            "fax_number": "201-880-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAMOUNT REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "201-880-6207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "40QA01528100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.