Individual provider Active NPI

Eve Dana Koppelman, P.T.

  • Physical Therapist
  • Montvale, NJ
National Provider Identifier
1609959642
Registry record updated Nov 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01124300 Issued in NJ
Practice address
210 Summit Ave Ste B1
Montvale, NJ 07645-1526
Phone
(201) 683-3500
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2019

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 025621 NY
Physical Therapist 225100000X 40QA01124300 NJ Primary

Addresses

Primary practice location

210 Summit Ave Ste B1
Montvale, NJ 07645-1526

Mailing address

11 Hilton PL
Montvale, NJ 07645-1206
Phone (201) 683-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000272 NJ Practitioner - Physical Therapist in Private Practice 6800888629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 Summit Ave
Suite B1
Montvale, NJ 07645-1526
Phone (201) 683-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025621NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mua Specialists LLC CurrentSince Sep 21, 2025 Accepting new patients
Homestay P.C. Physical Therapist CurrentSince Apr 15, 2019 Accepting new patients
Physical Therapy Lab Physical Therapist CurrentSince Dec 15, 2019 Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients
Encompass Health Rehabilitation Hospital of Florence, Inc. Past Accepting new patients
Empire State Occupational Therapy PC Past Accepting new patients
Rockland Physical Therapy PLLC Physical Therapist PastSince Feb 1, 2003 Accepting new patients

Locations

91 Ruckman Rd
Ste 2
Closter, NJ 07624

103 Somerset St
Garfield, NJ 07026
Phone (646) 645-0582

90 Main St
Ste 308
Hackensack, NJ 07601
Phone (201) 646-2500

210 Summit Ave
Ste B1
Montvale, NJ 07645
Phone (201) 683-3500

Organizations & group practices 7

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573862400000",
    "number": "1609959642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HILTON PL",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451206",
            "telephone_number": "201-683-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SUMMIT AVE STE B1",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451526",
            "telephone_number": "201-683-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPELMAN",
        "first_name": "EVE",
        "middle_name": "DANA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2019-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025621",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01124300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montvale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2019; 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.