Individual provider Active NPI

Michael Gregory Johncola Jr., PT, DPT

  • Physical Therapist
  • Sewell, NJ
National Provider Identifier
1609440361
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02065600 Issued in NJ
Practice address
570 Egg Harbor Rd Ste C2
Sewell, NJ 08080-2359
Phone
(609) 267-9400
Fax
(856) 270-2786
NPI assigned
May 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MD
Physical Therapist 225100000X PT029668 PA
Physical Therapist 225100000X 40QA02065600 NJ Primary

Addresses

Primary practice location

570 Egg Harbor Rd Ste C2
Sewell, NJ 08080-2359

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (609) 267-9400

Other practice location 1

711 W 40th St Ste 170
Baltimore, MD 21211-2147
Phone (667) 600-4560

Other practice location 2

300 W Route 38
Moorestown, NJ 08057-3424
Phone (609) 267-9400

Other practice location 3

614 Lambs Rd Unit C
Pitman, NJ 08071-2023
Phone (609) 267-9400

Other practice location 4

1919 Chestnut St Ste 104
Philadelphia, PA 19103-3456
Phone (215) 564-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210825001518 PA Practitioner - Physical Therapist in Private Practice 5193120491 Reassigns benefits to 2 organizations
I20220218001866 NJ Practitioner - Physical Therapist in Private Practice 5193120491 Reassigns benefits to 1 organization
I20240110000028 MD Practitioner - Physical Therapist in Private Practice 5193120491 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

3242 Route 206
Bordentown, NJ 08505-4517

570 Egg Harbor Rd
Sewell, NJ 08080-2359

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02065600NJMDPhysical Therapist
PT029668PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progress Physical Therapy LLC Physical Therapist CurrentSince Aug 6, 2021 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 19, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 12, 2023 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 19, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 12, 2023 Accepting new patients
Virtua Medical Group, PA Current Accepting new patients
Theraphysical Care of Pennsylvania, LLC Physical Therapist CurrentSince May 1, 2021 Accepting new patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince May 24, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

7624 Belair Rd
Baltimore, MD 21236
Phone (667) 219-2169

711 W 40th St
Ste 170
Baltimore, MD 21211
Phone (667) 600-4560

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

300 W Route 38
Moorestown, NJ 08057
Phone 60926794001224

614 Lambs Rd
Unit C
Pitman, NJ 08071
Phone (856) 256-0051

570 Egg Harbor Rd
Ste C2
Sewell, NJ 08080
Phone (856) 218-0300

570 Egg Harbor Rd
Ste C4
Sewell, NJ 08080
Phone (856) 256-0051

200 Bowman Dr
Ste 100
Voorhees, NJ 08043

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

306 Primrose Ln
Mountville, PA 17554
Phone (717) 522-1816

100 S Juniper St
Fl 3
Philadelphia, PA 19107
Phone (267) 999-9534

1919 Chestnut St
Ste 104
Philadelphia, PA 19103
Phone (215) 564-1110

Organizations & group practices 8

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": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1609440361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "609-267-9400",
            "fax_number": "856-270-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 EGG HARBOR RD STE C2",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "telephone_number": "609-267-9400",
            "fax_number": "856-270-2786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W 40th St Ste 170",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212112147",
            "country_code": "US",
            "telephone_number": "667-600-4560",
            "fax_number": "667-228-6002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W Route 38",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573424",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "856-234-3921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "614 Lambs Rd Unit C",
            "address_purpose": "LOCATION",
            "city": "Pitman",
            "state": "NJ",
            "postal_code": "080712023",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1919 Chestnut St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191033456",
            "country_code": "US",
            "telephone_number": "215-564-1110",
            "fax_number": "215-227-2739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNCOLA",
        "first_name": "MICHAEL",
        "middle_name": "GREGORY",
        "name_suffix": "Jr.",
        "credential": "PT,  DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029668",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02065600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.