Individual provider Active NPI

Carla M Difelice, MSPT

  • Physical Therapist
  • Waldwick, NJ
National Provider Identifier
1619906849
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA05979 Issued in NJ
Practice address
168 Franklin Tpke
Suite 103B
Waldwick, NJ 07463-1848
Phone
(201) 493-7440
Fax
(201) 493-7445
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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 QA05979 NJ Primary

Addresses

Primary practice location

168 Franklin Tpke
Suite 103B
Waldwick, NJ 07463-1848

Mailing address

168 Franklin Tpke
Suite 103B
Waldwick, NJ 07463-1848
Phone (201) 493-7440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070406000333 NJ Practitioner - Physical Therapist in Private Practice 4587768270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

1 Greenwood Ave
Montclair, NJ 07042-3649
Phone (973) 746-2424

668 Wyckoff Ave
Wyckoff, NJ 07481-1430
Phone (201) 891-0411

680 Kinderkamack Rd
Oradell, NJ 07649-1600
Phone (201) 225-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA05979NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Aug 28, 2019 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Aug 28, 2019 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

776 N Route 17
Paramus, NJ 07652
Phone (201) 225-9222

68 River Rd
Summit, NJ 07901
Phone (908) 277-0800

168 Franklin Tpke
Ste 103B
Waldwick, NJ 07463
Phone (201) 493-7440

668 Wyckoff Ave
Wyckoff, NJ 07481
Phone (201) 891-0400

576 Broadhollow Rd
Melville, NY 11747

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Organizations & group practices 5

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1619906849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 FRANKLIN TPKE",
            "address_2": "SUITE 103B",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631848",
            "telephone_number": "201-493-7440",
            "fax_number": "201-493-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 FRANKLIN TPKE",
            "address_2": "SUITE 103B",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631848",
            "telephone_number": "201-493-7440",
            "fax_number": "201-493-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFELICE",
        "first_name": "CARLA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA05979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldwick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.