Individual provider Active NPI

Lori Burchfield-Mikula

  • Physical Therapist
  • Bridgewater, NJ
National Provider Identifier
1558913053
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00704200 Issued in NJ
Practice address
872 E Main St
Bridgewater, NJ 08807-3395
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 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 40QA00704200 NJ Primary

Addresses

Primary practice location

872 E Main St
Bridgewater, NJ 08807-3395

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190812002562 NJ Practitioner - Physical Therapist in Private Practice 9032446174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Individual Physical Therapy and Wellness LLCGroup PAC ID 9335493857, 10 clinicians

Practice addresses (Care Compare)

644 Valley Rd
Gillette, NJ 07933-2012
Phone (908) 991-3761

Merit-based Incentive Payment System (MIPS)

Final score
90.19 of 100Reported as group
Quality
83.44
Improvement activities
40
Cost
89.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00704200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Services Physical Therapist CurrentSince Jul 10, 2024 Accepting new patients
Individual Physical Therapy and Wellness LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients

Locations

625 Springfield Ave
Berkeley Heights, NJ 07922
Phone (201) 600-5898

644 Valley Rd
Gillette, NJ 07933
Phone (908) 991-3761

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1558913053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 E MAIN ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073395",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHFIELD-MIKULA",
        "first_name": "LORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-09-06",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00704200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.