Individual provider Active NPI

Melissa Merino Goni, DPT

  • Physical Therapist
  • Englewood, NJ
National Provider Identifier
1639896046
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02133400 Issued in NJ
Practice address
102 Engle St
Englewood, NJ 07631-2938
Phone
(201) 992-4488
NPI assigned
Oct 26, 2022
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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 40QA02133400 NJ Primary

Addresses

Primary practice location

102 Engle St
Englewood, NJ 07631-2938

Mailing address

35 Madeline Ave Apt 2
Clifton, NJ 07011-2469
Phone (973) 272-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221128001595 NJ Practitioner - Physical Therapist in Private Practice 9931577848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

211 Berdan Ave
Wayne, NJ 07470-3236
Phone (201) 249-6930

266 Harristown Rd
Suite 200
Glen Rock, NJ 07452-3354
Phone (201) 445-7000

5605 Palisade Ave
West New York, NJ 07093-2125
Phone (551) 333-1867

5665 JFK Boulevard
Suite 7
North Bergen, NJ 07047-3223
Phone (973) 692-6400

634 Summit Ave
Jersey City, NJ 07306-3705
Phone (551) 355-0010

720 Bergen Ave
Jersey City, NJ 07306-4706
Phone (201) 857-0527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02133400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Physical Therapist CurrentSince Nov 7, 2022 Accepting new patients

Locations

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5905

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": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1639896046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MADELINE AVE APT 2",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112469",
            "telephone_number": "973-272-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312938",
            "telephone_number": "201-992-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERINO GONI",
        "first_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02133400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.