Individual provider Active NPI

Dominica Bianconi, PT, DPT

  • Physical Therapist
  • Fort Lee, NJ
National Provider Identifier
1659144095
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
158 Linwood PLZ Ste 308-310
Fort Lee, NJ 07024-3761
Phone
(201) 461-9333
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 NU Primary

Addresses

Primary practice location

158 Linwood PLZ Ste 308-310
Fort Lee, NJ 07024-3761

Mailing address

54 W 70TH St Apt 1a
New York, NY 10023-4650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213002603 NJ Practitioner - Physical Therapist in Private Practice 5395188767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Equilibrium LLCGroup PAC ID 7315256906, 4 clinicians

Practice addresses (Care Compare)

158 Linwood PLZ
Suite 308 310
Fort Lee, NJ 07024-3761
Phone (201) 461-9333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibrium, LLC Physical Therapist CurrentSince Jan 13, 2024 Accepting new patients

Locations

158 Linwood Plz
Ste 308310
Fort Lee, NJ 07024
Phone (201) 461-9333

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": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1659144095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W 70TH ST APT 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 LINWOOD PLZ STE 308-310",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243761",
            "telephone_number": "201-461-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCONI",
        "first_name": "DOMINICA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.