Individual provider Active NPI

Michael S. Holmgren, PT, DPT

  • Physical Therapist
  • Wayne, NJ
National Provider Identifier
1629093679
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01183200 Issued in NJ
Practice address
48 Fieldstone PL
Wayne, NJ 07470-6425
Phone
(201) 414-4085
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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 40QA01183200 NJ Primary

Addresses

Primary practice location

48 Fieldstone PL
Wayne, NJ 07470-6425

Mailing address

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936-3167
Phone (201) 414-4085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000016 NJ Practitioner - Physical Therapist in Private Practice 0941214308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

40 Main St
Chatham, NJ 07928-2431
Phone (973) 635-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01183200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince May 9, 2019 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince May 9, 2019 Accepting new patients
David S. Rosenstein, DC PC PastSince Apr 27, 2009 Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

40 Main St
Chatham, NJ 07928
Phone (973) 635-0800

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936
Phone (973) 887-0115

140 N Route 17
Ste 272
Paramus, NJ 07652
Phone (201) 261-4343

80 Oak Hill Rd
Red Bank, NJ 07701
Phone (732) 741-2313

111 W Water St
Toms River, NJ 08753
Phone (732) 473-9440

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1629093679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE",
            "address_2": "STE 201",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "201-414-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 FIELDSTONE PL",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706425",
            "telephone_number": "201-414-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMGREN",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01183200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

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