Individual provider Active NPI

Disha Patel, PT, DPT

  • Physical Therapist
  • Marlton, NJ
National Provider Identifier
1619366960
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01586100 Issued in NJ
Practice address
1 Sullivan Way
Marlton, NJ 08053-5315
Phone
(856) 520-9563
Fax
(856) 632-2789
NPI assigned
Jan 9, 2015
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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 40QA01586100 NJ Primary

Addresses

Primary practice location

1 Sullivan Way
Marlton, NJ 08053-5315

Mailing address

542 Berlin Cross Keys Rd
Winslow Plaza Suite 1
Sicklerville, NJ 08081-4367
Phone (856) 740-0009

Other practice location 1

3131 NJ-38, Suite 11-B
Mount Laurel, NJ 08054
Phone (856) 554-2770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01586100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bliss Physical Therapy and Pilates Physical Therapist CurrentSince Jul 21, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1619366960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 BERLIN CROSS KEYS RD",
            "address_2": "WINSLOW PLAZA SUITE 1",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080814367",
            "telephone_number": "856-740-0009",
            "fax_number": "856-262-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SULLIVAN WAY",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080535315",
            "telephone_number": "856-520-9563",
            "fax_number": "856-632-2789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 NJ-38, Suite 11-B",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "08054",
            "country_code": "US",
            "telephone_number": "856-554-2770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DISHA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01586100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.