Individual provider Active NPI

Alexa Desantis, PT, DPT

  • Physical Therapist
  • Little Silver, NJ
National Provider Identifier
1558170803
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02308100 Issued in NJ
Practice address
160 White Rd Ste 104
Little Silver, NJ 07739-1167
Phone
(732) 383-8295
NPI assigned
Jan 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 40QA02308100 NJ Primary

Addresses

Primary practice location

160 White Rd Ste 104
Little Silver, NJ 07739-1167

Mailing address

160 White Rd Ste 104
Little Silver, NJ 07739-1167
Phone (732) 383-8295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121000277 NJ Practitioner - Physical Therapist in Private Practice 4789113762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Physical Therapy & Sports Care LLC Physical Therapist CurrentSince Jan 15, 2025 Accepting new patients
Proactive Sports Care and Rehabilitation,PC Physical Therapist CurrentSince Jan 5, 2025 Accepting new patients

Locations

160 White Rd
Ste 104
Little Silver, NJ 07739
Phone (732) 383-8295

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": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1558170803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 WHITE RD STE 104",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391167",
            "telephone_number": "732-383-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WHITE RD STE 104",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391167",
            "telephone_number": "732-383-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "ALEXA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02308100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Silver, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.