Organization Active NPI

Opt Physical Therapy and Wellness LLC

  • Physical Therapist
  • Oak Ridge, NJ
National Provider Identifier
1659404457
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QAO2733 Issued in NJ
Legal business name
OPT PHYSICAL THERAPY AND WELLNESS LLC
Practice address
5758 Berkshire Valley Road
Oak Ridge, NJ 07438-2685
Phone
(973) 697-3460
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rajeshwari Doraiswamy, DPTNPI 1528256591
Title
Physical Therapist
Phone
(973) 697-3460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X QAO2733 NJ Primary

Addresses

Primary practice location

5758 Berkshire Valley Road
Oak Ridge, NJ 07438-2685

Mailing address

PO Box 241
Towaco, NJ 07082-0241

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040430000077 NJ Part B Supplier - Clinic/Group Practice 5496742488 Receives reassigned benefits from 6 practitioners
Practice locations: Lake Hopatcong, NJ; Oak Ridge, NJ

National Provider Directory

National Provider Directory

Locations

1395 Route 23
Butler, NJ 07405
Phone (973) 831-5360

706 State Route 15 S
Ste 102
Lake Hopatcong, NJ 07849
Phone (973) 663-5925

5758 Berkshire Valley Rd
Oak Ridge, NJ 07438
Phone (973) 697-3460

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1659404457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241",
            "city": "TOWACO",
            "state": "NJ",
            "postal_code": "070820241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5758 BERKSHIRE VALLEY ROAD",
            "city": "OAK RIDGE",
            "state": "NJ",
            "postal_code": "074382685",
            "telephone_number": "973-697-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPT PHYSICAL THERAPY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "DORAISWAMY",
        "authorized_official_first_name": "RAJESHWARI",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "973-697-3460",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QAO2733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.